男性外生殖器开放性损伤诊治体会

The Diagnosis and Treatment for Open Injury in Male External Genitalia

目的 :提高男性外生殖器开放性损伤的诊治水平。 方法 :分析 2 4例男性外生殖器开放性损伤的临床资料。其中儿童 7例 ,成人 17例 ,合并同侧睾丸和 /或附睾裂伤 4例 ,对侧睾丸裂伤 1例 ,睾丸血肿 1例 ,精索离断伤 2例 ,尿道损伤 4例 ,阴茎海绵体破裂 2例。致伤原因以车祸为主 ,占 42 % (10 /2 4)。 结果 :全组均作急诊手术 ,2例作二期手术 ,伤口感染 3例。随访 19例 (79% ) ,时间 1～ 3年 ,无发生排尿困难、尿瘘、阴茎弯曲、睾丸坏死、睾丸萎缩等并发症。 结论 :对男性外生殖器开放性损伤 ,应进一步了解是否合并海绵体、尿道和阴囊内容物的损伤 ,并作正确的处理 ,防止并发症发生。对阴茎或阴囊皮肤缺损较大病人 ,可作二期手术修复。

Objectives: To improve the efficacy of diagnosis and treatment for the open injury in male external genitalia. Methods: Information of 24 patients with open injury in male external genitalia was reviewed. Results: There were 7 cases of children and 17 of adults. Complex injury was found in the 24 case, with trauma of testis and/or epididymis in 4 on the same side and 2 on the other side, injury of spermatic cord in 2, injury of urethra in 4, fracture of the penis in 2. The main cause of wound was traffic accidents (42%). Emergency operation were undertaken in all, and second peroid operation were done in 2 cases. Wound infection occurred in 3 patients. 19 cases (79%) were followed up for 1～3 years, but no complications including dysuria, urethral fistula, curvature of penis, testicular necrosis and atrophy were observed. Conclusions: The complex injury including cavernosum, urethra and contents of scrotum must be identified with open injury in male external genitalia. The second period operation is suggested for patients in whom more damage or less is found on skin of penis and scrotum.