阴茎骨折的早期诊断与治疗  

Early diagnosis and treatment of fracture penis

作　　者：钱晓辉[1] 黄河[1] 饶建明 陈涛[1] Qian Xiaohui;Huang He;Rao Jianming;Chen Tao(Department of Uology,The Fouth Hospital of Changsha,Changsha,Hunan,410006,China)

机构地区：[1]长沙市第四医院泌尿外科,湖南长沙410006

出　　处：《当代医学》2020年第29期85-88,共4页Contemporary Medicine

摘　　要：目的探讨阴茎骨折早期诊断与治疗的价值和预后。方法回顾性分析2013年1月至2018年6月本院收治的20例阴茎骨折患者的临床资料,并在门诊复诊对患者进行回访。其中18例患者进行阴茎探查术,2例患者选择保守治疗。术后评估患者勃起和排尿功能,所有患者随访至少6个月。结果患者年龄20~60岁,平均(36.5±14.0)岁;发病后就诊时间2 h^7 d,平均就医时间(26.8±4.0)h。20例患者中,18例是在性交时受伤,1例患者在手淫时受伤,还有1例患者勃起时坠床所致;有3例患者合并尿道损伤;术后平均随访时间为6~42个月,平均(22.5±8.5)个月,术后无患者出现长期并发症,所有患者的勃起功能恢复至术前,其中1例在术后短期内出现勃起功能障碍,在口服西地那非后得到恢复,远期观察,未出现排尿功能障碍、阴茎弯曲或性功能障碍。结论阴茎骨折可以通过病史采集、临床体检确诊,不需要常规进行阴茎海绵体造影,早期诊断、腹侧正中切口手术修复,可保留勃起和排尿功能。Objective To explore the value and prognosis of early diagnosis and treatment of penile fractures.Methods The clinical data of 20 patients with penile fracture admitted in our hospital from January 2013 to June 2018 were retrospectively analyzed,and the patients were revisited in the outpatient clinic.Among them,18 patients underwent penile exploration,and 2 patients chose conservative treatment.Postoperative evaluation of patients'erection and urination function,all patients were followed up for at least 6 months.Results The patients were 20 to 60 years old,with an average of(36.5±14.0)years old.The duration of treatment was 2 h to 7 d after onset,and the average duration of treatment was(26.8±4.0)h.Of the 20 patients,18 were injured during intercourse,1 was injured during masturbation,and 1 was caused by falling into bed during erection.There were 3 patients with urethral injury.The average follow-up time after surgery was 6 to 42 months,with an average of(22.5±8.5)months.There were no long-term complications after the operation,and all patients had erectile function restored to the preoperative period.One of them had erectile dysfunction in the short term after surgery.After oral sildenafil recovery,long-term observation showed no urinary dysfunction,penile curvature or sexual dysfunction.Conclusion Penile fractures can be diagnosed through medical history collection and clinical physical examination.Routine cavernous angiography is not required.Early diagnosis and repair of ventral median incision can preserve erection and urination.

关 键 词：阴茎骨折 尿道损伤 诊断与治疗 

分 类 号：R697.15[医药卫生—泌尿科学]