Treatment of urethral trauma in penile fracture

封面


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

BACKGROUND: Penile fracture is a rare injury that most often occurs during intercourse. In 2–38 % of cases, a penile fracture is accompanied by an injury to the urethra.

AIM: To determine rational treatment of patients with urethral injuries of varying severity as a result of a penile fracture.

MATERIALS AND METHODS: The retrospective group of the study included 8 patients in whom a penile fracture was accompanied by an injury to the urethra. Among them, in 6 (75%) patients, along with a rupture of the albuginea and urethra, unilateral damage of cavernous body was observed. The severity of trauma to the penis and urethra was assessed according to the classification of the American Association for the Surgery of Trauma (AAST).

RESULTS: According to the diagnostic results, the fracture of the penis in all patients corresponded to the grade III according to the AAST classification. Urethral injury in 7 patients was grade III, and one was grade I according to the AAST classification. Patients with grade III urethral injury underwent primary urethral plastic surgery. A patient with grade I was treated conservatively. In all patients the bladder was drained with a urethral catheter. Penile fracture was treated surgically in all cases.

CONCLUSIONS: A penile fracture associated with urethral trauma always requires immediate surgical treatment. In case of injuries of the urethra I–II grade according to AAST, the urethral catheter installation and conservative management are indicated. In case of injury of the urethra III, IV, V grade according to AAST, urgent primary urethroplasty is necessary. Damage to the corpora cavernosa and albuginea require surgical treatment after restoration of the integrity of the urethra.

全文:

受限制的访问

作者简介

Gocha Shanava

Dzhanelidze Research Institute of Emergency Medicine; Almazov National Medical Research Centre

编辑信件的主要联系方式.
Email: dr.shanavag@mail.ru
SPIN 代码: 1706-7410

Cand. Sci. (Med.), Associate Professor of the Department of Urology with Course of Robotic Surgery and Clinic, Urologist

俄罗斯联邦, 3A Budapeshtskaya st., Saint Petersburg, 192242; Saint Petersburg

Mkrtich Mosoyan

Almazov National Medical Research Centre; Academician I.P. Pavlov First St. Petersburg State Medical University

Email: moso03@yandex.ru
ORCID iD: 0000-0003-3639-6863
SPIN 代码: 5716-9089
Scopus 作者 ID: 57208982777

MD, Dr. Sci. (Med.), head of the Department of Urology with the Course of Robotic Surgery and the Clinic, head of the Center for Robotic Surgery, professor of the Department of Urology

俄罗斯联邦, Saint Petersburg; 6-8 Lva Tolstogo st., Saint Petersburg, 197022

Alexey Sivakov

Dzhanelidze Research Institute of Emergency Medicine

Email: alexei-sivakov@mail.ru
SPIN 代码: 3064-8134

MD, Cand. Sci. (Med.), assistant professor, head of the Urological Unit

俄罗斯联邦, 3A Budapeshtskaya st., Saint Petersburg, 192242

Georgii Shanava

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: dr.shanavag@mail.ru

student

俄罗斯联邦, 6-8 Lva Tolstogo st., Saint Petersburg, 197022

参考

  1. Kominsky H, Beebe S, Shah N, Jenkins LC. Surgical reconstruction for penile fracture: a systematic review. Int J Impot Res. 2020;32(1):75–80. doi: 10.1038/s41443-019-0212-1
  2. Kati B, Akin Y, Demir M, et al. Penile fracture and investigation of early surgical repair effects on erectile dysfunction. Urologia. 2019;86(4):207–210. doi: 10.1177/0391560319844657
  3. Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current management of penile fracture: an up-to-date systematic review. Sex Med Rev. 2018;6(2):253–260. doi: 10.1016/j.sxmr.2017.07.009
  4. Cerone JS, Agarwal P, McAchran S, Seftel A. Penile fracture with isolated corpus spongiosum injury. Int J Impot Res. 2006;18(2):218–220. doi: 10.1038/sj.ijir.3901389
  5. Pariser JJ, Pearce SM, Patel SG, Bales GT. National patterns of urethral evaluation and risk factors for urethral injury in patients with penile fracture. Urology. 2015;86(1):181–185. doi: 10.1016/j.urology.2015.03.039
  6. Amit A, Arun K, Bharat B, et al. Penile fracture and associa ted urethral injury: Experience at a tertiary care hospital. Can Urol Assoc J. 2013;7(3–4): E168–E170. doi: 10.5489/cuaj.475
  7. Basok SM, Kyzlasov PS, Kobzarev AP, et al. Surgical treatment of blunt trauma (fracture) of the penis with damage to the urethra. Urologicheskie vedomosti. 2018;8(4):33–36. (In Russ.) doi: 10.17816/uroved8433-36
  8. Gedik A, Kayan D, Yamiş S, et al. The diagnosis and treatment of penile fracture: our 19-year experience. Ulus Travma Acil Cerrahi Derg. 2011;17(1):57–60.
  9. Yamaçake KG, Tavares A, Padovani GP, et al. Long-term treatment outcomes between surgical correction and conservative management for penile fracture: retrospective analysis. Korean J Urol. 2013;54(7):472–476. doi: 10.4111/kju.2013.54.7.472
  10. El-Assmy A, El-Tholoth HS, Mohsen T, Ibrahiem el HI. Long-term outcome of surgical treatment of penile fracture complicated by urethral rupture. J Sex Med. 2010;7(11):3784–3788. doi: 10.1111/j.1743-6109.2009.01653.x
  11. Barros R, Silva M, Antonucci V, et al. Primary urethral reconstruction results in penile fracture. Ann R Coll Surg Engl. 2018;100(1):21–25. doi: 10.1308/rcsann.2017.0098

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Penile fracture

下载 (99KB)
索引源数据
3. Fig. 2. Surgical access to the corpora cavernosa and urethra. Hematoma in the area of ruptured Buck’s fascia (white arrow)

下载 (120KB)
索引源数据
4. Fig. 3. Urethral injury in penile fracture

下载 (114KB)
索引源数据
5. Fig. 4. The 14th day after the reconstructive surgery

下载 (91KB)
索引源数据

版权所有 © Eco-Vector, 2023


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ №ФС77-65570 от 04 мая 2016 г.


##common.cookie##