Uretroplastia término terminal y reconstrucción cavernosa temprana en ruptura bilateral de origen traumático

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dc.contributor.authorVargas Silva, Marcos David
dc.contributor.authorOrtiz Zableh, Ana María
dc.contributor.authorVillareal Trujillo, Nicolás
dc.contributor.authorSarmiento Sarmiento, Guillermo
dc.date.accessioned2024-08-08T20:45:47Z
dc.date.available2024-08-08T20:45:47Z
dc.date.issued2022-03-01
dc.description.abstractLa fractura de pene es una emergencia urológica rara, se desconoce la incidencia real dado el subregistro causado por la reducida consulta de los pacientes, resultado del embarazoso contexto. En Estados Unidos alcanza un 38% donde la etiología de índole sexual predomina. En Colombia hay escasos reportes publicados. El diagnóstico de esta entidad es netamente clínico. El objetivo de este trabajo es reportar una evolución satisfactoria en términos de función miccional y eréctil en un paciente sometido a reconstrucción cavernosa y uretral temprana en rotura bilateral de origen traumático mediante una técnica quirúrgica poco convencional, de acuerdo con lo hallado en la literatura. Presentación del caso. Paciente masculino de 30 años, previamente sano, quien consultó al servicio de urgencias por uretrorragia, edema y dolor peneano secundario a trauma contuso del mismo durante relación sexual. El reporte ecográfico mostró disrupción en túnica albugínea del cuerpo esponjoso, hematoma y aparente transección uretral; se realizó exploración quirúrgica 6 horas después, con evidencia de fractura de cuerpos cavernosos, laceración del 40% de la circunferencia, transección completa de la uretra y cuerpo esponjoso. Se realizó rafia de cuerpos cavernosos y uretroplastia término terminal de uretra bulbar, con evolución clínica satisfactoria. Discusión. La reconstrucción quirúrgica en menos de 24 horas en fractura de pene disminuye significativamente la estancia hospitalaria y complicaciones precoces; asimismo, desciende el riesgo de disfunción eréctil, erecciones dolorosas y problemas miccionales. No hay publicaciones que comparen resultados a largo plazo entre los dos abordajes quirúrgicos. Conclusiones. La fractura de pene es una patología poco frecuente con diagnóstico clínico, la cual debe manejarse de manera temprana por cualquier urólogo y, en caso de ser posible, con experiencia reconstructiva y excelentes resultados en la función sexual y miccional.spa
dc.description.abstractenglishPenile fracture is a rare urological emergency, the real incidence is unknown given the underreporting caused by the reduced consultation of patients, resulting from the embarrassing context. In the United States it reaches 38%, where sexual etiology predominates. In Colombia there are few published reports. The diagnosis of this entity is purely clinical. The aim of this work is to report a satisfactory evolution in terms of voiding and erectile function in a patient who underwent early cavernous and urethral reconstruction in bilateral rupture of traumatic origin by means of an unconventional surgical technique, in accordance with what has been found in the literature. Case Presentation. A 30-year-old male patient, previously healthy, consulted the emergency department for urethrorrhagia, edema and penile pain secondary to blunt trauma to the penis during sexual intercourse. The ultrasound report showed disruption in the tunica albuginea of the corpus spongiosum, hematoma and apparent urethral transection; surgical exploration was performed 6 hours later, with evidence of fracture of the corpora cavernosa, laceration of 40% of the circumference, complete transection of the urethra and corpus spongiosum. Sutures to the corpora cavernosa and end-to-end urethroplasty of the bulbar urethra were performed, with satisfactory clinical evolution. Discussion. Surgical reconstruction in less than 24 hours in penile fractures significantly reduces hospital stay and early complications; it also reduces the risk of erectile dysfunction, painful erections and voiding problems. There are no publications comparing long-term results between the two surgical approaches. Conclusions. Penile fracture is a rare pathology with clinical diagnosis, which should be managed early by any urologist and, if possible, with reconstructive experience and excellent results in sexual and voiding function.eng
dc.description.abstractotherA fratura peniana é uma emergência urológica rara, a real incidência é desconhecida dada a subnotificação causada pela reduzida consulta de pacientes, resultado do contexto constrangedor. Nos Estados Unidos chega a 38% onde predomina a etiologia de natureza sexual. Na Colômbia há poucos relatórios publicados. O diagnóstico desta entidade é puramente clínico. O objetivo deste trabalho é relatar uma evolução satisfatória da função miccional e erétil em um paciente submetido à reconstrução cavernosa e uretral precoce em ruptura bilateral de origem traumática por meio de técnica cirúrgica não convencional, de acordo com o que foi encontrado na literatura. Apresentação do caso. Paciente do sexo masculino, 30 anos, previamente saudável, procurou o pronto-socorro por uretrorragia, edema e dor peniana secundária a trauma contuso durante a relação sexual. O relatório do ultrassom mostrou ruptura na túnica albugínea do corpo esponjoso, hematoma e transecção uretral aparente; a exploração cirúrgica foi realizada 6 horas depois, com evidência de fratura dos corpos cavernosos, laceração de 40% da circunferência, transecção completa da uretra e corpo esponjoso. Foram realizadas ráfia dos corpos cavernosos e uretroplastia término-terminal da uretra bulbar, com evolução clínica satisfatória. Discussão. A reconstrução cirúrgica em menos de 24 horas nas fraturas penianas reduz significativamente o tempo de internação e as complicações precoces. Da mesma forma, diminui o risco de disfunção erétil, ereções dolorosas e problemas de micção. Não há publicações comparando os resultados a longo prazo entre as duas abordagens cirúrgicas. Conclusões. A fratura peniana é uma patologia rara com diagnóstico clínico, que deve ser tratada precocemente por qualquer urologista e, se possível, com experiência reconstrutiva e excelentes resultados na função sexual e miccional.por
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.29375/01237047.4073
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga UNABspa
dc.identifier.issni-ISSN 0123-7047spa
dc.identifier.issne-ISSN 2382-4603spa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/25959
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/4073/3594spa
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dc.relation.urihttps://revistas.unab.edu.co/index.php/medunab/issue/view/281spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.sourceVol. 25 Núm. 1 (2022): abril - julio 2022: Enfermedades Respiratorias, Telemedicina, Uso de Tabaco; 59-65spa
dc.subjectPenespa
dc.subjectErección Penianaspa
dc.subjectUretraspa
dc.subjectHeridas y Lesionesspa
dc.subjectProcedimientos Quirúrgicos Reconstructivosspa
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsPeniseng
dc.subject.keywordsPenile Erectioneng
dc.subject.keywordsUrethraeng
dc.subject.keywordsWounds and Injurieseng
dc.subject.keywordsReconstructive Surgical Procedureseng
dc.subject.keywordsHealth scienceseng
dc.subject.keywordsCiências médicaspor
dc.subject.keywordsCiências da vidapor
dc.subject.keywordsCiências da saúdepor
dc.subject.keywordsPênispor
dc.subject.keywordsEreção Penianapor
dc.subject.keywordsUretrapor
dc.subject.keywordsFerimentos e Lesõespor
dc.subject.keywordsProcedimentos Cirúrgicos Reconstrutivospor
dc.subject.lembCiencias médicasspa
dc.subject.lembCiencias de la vidaspa
dc.subject.lembCiencias de la saludspa
dc.titleUretroplastia término terminal y reconstrucción cavernosa temprana en ruptura bilateral de origen traumáticospa
dc.title.translatedEnd-to-End Urethroplasty and Early Cavernous Reconstruction in Bilateral Rupture of Traumatic Origineng
dc.title.translatedUretroplastia término-terminal e reconstrução cavernosa precoce em rotura bilateral de origem traumáticapor
dc.typeArticleeng
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículospa
dc.type.redcolhttp://purl.org/redcol/resource_type/ART

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