背景:最新的欧洲泌尿外科协会(EAU)泌尿外科创伤指南于2014年发表。
目的:总结2014版EAU关于下尿路泌尿系创伤的指南,重点是诊断和治疗。
方法:EAU创伤小组通过Medline搜索下尿路损伤(LUTI)回顾了截至2013年11月的英语文献。重点是更新的出版物和评论,尽管可以包括较旧的关键参考文献。
结果:指南的完整版本已印刷(EAU指南2014版,ISBN/EAN978-90-79754-65-6)和在线(www。uroweb.org)。钝性创伤是LUTI的主要病因。膀胱和尿道损伤的首选诊断方式是膀胱造影和尿道造影。分别。在膀胱损伤的治疗中,区分腹膜外破裂和腹膜内破裂很重要.男性前尿道损伤的治疗取决于原因(钝性,穿透性,阴茎骨折相关损伤)。钝性后尿道损伤可以通过立即/早期内窥镜重新对准来纠正。如果这是不可能的,此类损伤可通过耻骨上尿路改道和延期(>3个月)尿道成形术来治疗。女性尿道损伤的治疗取决于损伤的位置,通常是手术。
结论:正确治疗LUTIs对于减少长期泌尿症状和性功能障碍非常重要。EAU创伤小组进行的这篇综述总结了LUTI的当前管理。
结果:下尿路创伤患者根据其损伤的性质和严重程度,从准确的诊断和适当的治疗中受益。
BACKGROUND: The most recent European Association of Urology (EAU)
guidelines on urologic trauma were published in 2014.
OBJECTIVE: To present a summary of the 2014 version of the EAU
guidelines on urologic trauma of the lower urinary tract with an emphasis on diagnosis and treatment.
METHODS: The EAU Trauma Panel reviewed the English-language literature via a Medline search for lower urinary tract injury (LUTI) up to November 2013. The focus was on newer publications and reviews, although older key references could be included.
RESULTS: A full version of the
guidelines is available in print (EAU
Guidelines 2014 edition, ISBN/EAN 978-90-79754-65-6) and online (www.uroweb.org). Blunt trauma is the main cause of LUTI. The preferred diagnostic modality for bladder and urethral injury is cystography and urethrography, respectively. In the treatment of bladder injuries, it is important to distinguish between extra- and intraperitoneal ruptures. Treatment of male anterior urethral injuries depends on the cause (blunt vs penetrating vs penile-fracture-related injury). Blunt posterior urethral injuries can be corrected by immediate/early endoscopic realignment. If this is not possible, such injuries are managed by suprapubic urinary diversion and deferred (>3 mo) urethroplasty. Treatment of female urethral injuries depends on the location of the injury and is usually surgical.
CONCLUSIONS: Correct treatment of LUTIs is important to minimise long-term urinary symptoms and sexual dysfunction. This review performed by the EAU trauma panel summarises the current management of LUTIs.
RESULTS: Patients with trauma to the lower urinary tract benefit from accurate diagnosis and appropriate treatment according to the nature and severity of their injury.