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Penile fracture: diagnosis, treatment and outcomes of 150 patients.

机译:阴茎骨折:150例患者的诊断,治疗和结果。

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OBJECTIVE: To report the diagnosis, treatment options, and outcomes of 150 patients with suspicion of penile fracture. MATERIALS AND METHODS: We analyzed 150 patients with clinically suspected penile fracture (PF). The patients were divided into two groups: group 1 (G1) with low suspicion of penile fracture (n = 25), and group 2 (G2) with high suspicion of penile fracture (n = 125). Complementary image methods were conducted on 59 patients (39.3%), with ultrasonography (USG) performed on 37 (24.6%) patients and magnetic resonance imaging on only one (0.6%). Retrograde urethrocystogram was performed when urethral injury was suspected (21 patients, 14%). In G1, all patients underwent USG to complement diagnosis. In G2, 12 patients underwent USG owing to a doubtful diagnosis. Mean follow-up was 34.6 months. RESULTS: All patients in G1 were able to achieve erection after the initial traumatic event and immediate penile detumescence did not occur in any of the cases. Of the 125 patients evaluated in G2, 110 (92%) presented with disruption of the tunica albuginea and 15 (8%) showed injury of the dorsal vein of the penis. Urethral injury was found in 20 (16%) patients and was always associated with corpus cavernosum injury. Among 110 cases of PF, 95 (86.3%) presented with unilateral and 15 (13.7%) presented with bilateral lesions. CONCLUSIONS: Patients with high suspicion of PF should be treated surgically. However, in cases of low suspicion of corpora cavernosum injury, based on clinical criteria and imaging methods, conservative treatment is a feasible and safe option.
机译:目的:报告150例怀疑阴茎折断的患者的诊断,治疗选择和结果。材料与方法:我们分析了150例临床怀疑为阴茎折断(PF)的患者。将患者分为两组:第一组(G1)怀疑阴茎骨折(n = 25),第二组(G2)怀疑阴茎骨折(n = 125)。对59例患者(39.3%)进行了补充成像方法,对37例患者(24.6%)进行了超声检查(USG),仅对一名患者(0.6%)进行了磁共振成像。怀疑尿道损伤时行逆行尿道膀胱造影检查(21例,占14%)。在G1中,所有患者均接受USG补充诊断。在G2中,有12位患者由于诊断不确定而接受了USG治疗。平均随访34.6个月。结果:G1的所有患者在最初的创伤事件后都能够勃起,并且在任何情况下都没有发生立即的阴茎消肿。在G2中评估的125位患者中,有110位(92%)表示白膜破裂,而15位(8%)表示阴茎背静脉受伤。在20名患者中发现了尿道损伤(16%),并且总是与海绵体损伤相关。在110例PF中,95例(86.3%)表现为单侧,15例(13.7%)表现为双侧病变。结论:高度怀疑PF的患者应通过手术治疗。但是,在怀疑海绵体损伤的情况下,根据临床标准和影像学方法,保守治疗是一种可行且安全的选择。

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