澳大利亚阴茎骨折修复术十年多中心经验总结

Matthew Yii, Chrisdan Gan, K. Qin, Damien Bolton, Gideon Blecher
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摘要

目的和方法:阴茎骨折是泌尿外科的急症,涉及阴茎海绵体白膜破裂。众所周知,地理位置对骨折病因有影响,而较高的影响病因被认为易使患者遭受复杂的创伤。为了回顾澳大利亚骨折修复术后的长期泌尿和性功能结果,我们对三个大都市医院服务部门 10 年来的数据进行了回顾性分析。该研究仅纳入了经术中确认的骨折患者。临床医生会与患者取得联系,让他们填写一份调查表,调查表采用的是经过验证的问卷,包括国际勃起功能指数-5(IIEF-5)和国际前列腺症状评分(IPSS)。围手术期数据与调查回答进行了对比分析。结果:我们确定了 55 例确诊阴茎骨折。21名患者完成了问卷随访,组成了研究队列。受伤时的中位年龄为 44.8 岁(范围:25-65 岁)。从受伤到完成问卷调查的中位时间为 4.0 年(范围:1-10 年)。此外,95.5%(20 例)的损伤发生在性交过程中。IIEF-5 评分中位数为 23(范围:5-25);IPSS 评分中位数为 5(范围:0-22)。七名患者(33.3%)受到双侧海绵体损伤,八名患者(38.1%)受到尿道损伤。经曼-惠特尼 U 检验,未发现双侧海绵体损伤与 IIEF-5 评分(P = 0.7377)或尿道损伤与 IPSS 评分(P = 0.5338)之间存在显著关系。结论澳大利亚阴茎骨折的病因似乎与其他西方国家一致,双侧阴茎海绵体和尿道损伤的发生率较高。观察到的长期勃起和排尿功能结果令人鼓舞。更大规模的前瞻性研究将进一步阐明损伤因素与结果之间的关系,并揭示由于队列规模和随访率方面的研究限制而未在本文中介绍的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A 10-Year Multicentre Experience of Australian Penile Fracture Repair Outcomes
Objectives and Methods: Penile fractures are a urologic emergency involving the rupture of the tunica albuginea of the corpora cavernosum. Geography is known to impact fracture aetiology, and higher impact aetiology is thought to predispose patients to complex trauma. To review long-term urinary and sexual outcomes following fracture repair in Australia, a retrospective analysis of data from three metropolitan hospital services over 10 years was performed. Only patients with intraoperatively confirmed fractures were included. Patients were contacted by clinicians to complete a survey, which utilised validated questionnaires, including the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). Perioperative data were analysed against survey responses. Results: We identified 55 confirmed penile fractures. Twenty-one patients completed questionnaire follow-ups, comprising the study cohort. The median age at the time of the injury was 44.8 years (range: 25–65). The median time from injury to questionnaire completion was 4.0 years (range: 1–10). Furthermore, 95.5% (20) of the injuries occurred during sexual intercourse. The median IIEF-5 score was 23 (range: 5–25); the median IPSS score was 5 (range: 0–22). Seven patients (33.3%) sustained a bilateral cavernosal injury, and eight (38.1%) sustained a urethral injury. Upon conducting a Mann–Whitney U test, no significant relationships were found between bilateral cavernosal injury and IIEF-5 scores (p = 0.7377) or urethral injury and IPSS scores (p = 0.5338). Conclusions: The Australian aetiology of penile fractures appears consistent with that of other Western countries, with subsequent high rates of bilateral cavernosal and urethral injuries. The long-term erectile and urinary function outcomes observed are promising. A larger prospective study would further illuminate the relationship between injury factors and outcomes, revealing information not presented herein due to study limitations relating to the cohort size and follow-up rates.
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