รายงานผู้ป่วยองคชาติหักและทบทวนวรรณกรรม
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ก.ย. 25, 2018
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บทคัดย่อ
องคชาติหัก (Penile Fracture) เป็นภาวะฉุกเฉินทางศัลยศาสตร์ระบบปัสสาวะ ซึ่งพบไม่บ่อย โดย เฉพาะอย่างยิ่งในประเทศไทย องคชาติหักเกิดจากการฉีกขาดของชั้น Tunica albuginea ของ Corpus cavemosum ในขณะที่อวัยวะเพศแข็งตัว การวินิจฉัยส่วนใหญ่ สามารถทำได้โดยการซักประวัติ และตรวจร่างกายเท่านั้น การวินิจฉัยและการรักษาที่ไม่ถูกต้องในเวลาที่เหมาะสม อาจก่อให้เกิดภาวะ แทรกซ้อนต่างๆ มากมาย เนื่องจากการรายงานผู้ป่วยมีไม่มากทำให้การวินิจฉัยและการรักษายังไม่มี ข้อสรุปที่ชัดเจน
บทความนี้ได้มีการทบทวนวรรณกรรมเกี่ยวกับองคชาติหัก และนำเสนอรายงาน ผู้ป่วย ชาย อายุ 31 ปี จับอวัยวะเพศกดลงขณะที่แข็งตัว เพี่อใส่ลงในกางเกง แล้วเกิดเสียง snapping sound หลังจาก นั้นอวัยวะเพศอ่อนตัวลงอย่างรวดเร็ว ร่วมกับมีอาการบวมและปวดที่อวัยวะเพศมาก ได้รับการวินิจฉัย องคชาติหัก และได้รับการรักษาโดย Immediate Surgical exploration and corporal repair ผลการ ติดตามการรักษาหลังผ่าตัด พบว่า Erection Function Voiding Function และ Cosmetic Result ดี
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References
1. Kochakam W, Viseshsindh V, Muangmun V. Penile fracture: long-term outcome of treatment. J Med Assoc Thai 2002;85(2):179-82.
2. Eke N. Fracture of the penis. Br J Surg 2002;89(5):555-65.
3. Klemen Jagodic, Marko Erklavec, Igor Bizjak, Sandi Poteko, Helena Korosec Jagodi. A case of penile fracture with complete urethral disruption during sexual intercourse : a case report. J Med Case Reports 2007;1:14.
4. Martinez RJ, Pastor Navarro H, Carrion Lopez P, Gimenez Bachs JM, Donate MM, Virseda Rodriguez JA. Fracture of the penis: a case series. Actas Urol Esp 2008;32(6):599-602.
5. Pandyan GV, Zaharani AB, A1 Rashid M. Fracture Penis: An Analysis of 26 cases. Scientific World Journal 2006;6:2327-33.
6. Bhuiyan ZH, Khan SA, Tawhid MH, Islam MF. Personal series with clinical review of fracture penis. Mymensingh Med J 2007;16(2):187-90.
7. Gregory S. Jack, Isla Garraway, Richard Reznichek, Jacob Rajfer. Current Treatment Options for Penile fractures. Rev Urol 2004;6(3):114-20.
8. El Atat R, Sfaxi M, Benslama MR, Amine D, Ayed M, Mouelli SB,et al. Fracture of the penis: management and long-term results of surgical treatment. Experience in 300 cases. J Trauma 2008;64(1):121-5.
9. Ghilan AM, Al-Asbahi WA, Ghafour MA, Alwan MA, Al-Khanbashi OM. Management of penile fractures. Saudi Med J 2008;29(10):1443-7.
10. Garcia Marchinena P, Capiel L, Juarez D, Liyo J, Giudice C, Gueglio G, Damia O. Penile fracture with associated urethra lesion : Case report and bibliographer review. Arch Esp Urol 2008;61(8):936-9.
11. Hanson GR, Thrasher JB. Urethral diverticalum as a sequela of unrepaired penile fracture. Can J Urol 2007;14(1):3461-2.
12. De Rose AF, Giglio M, Carmignani G. Traumatic rupture of the corpora cavernosa : new physiopathologic acquisitions. Urology 2001;57(2):319-22.
13. Mydlo JH. Surgeon experience with penile fracture. J Urol 200;166(2):526-9.
14. Mallis J. Zur Kausuistik der fractura penis. Arch Klin Chir 1924;129: 651.
15. Eke N. Fracture of the penis. Br J Surg 2001;89:555-65.
16. Bitsch M, Kromann-andersen B, Schou J, Sjontoft E. The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. J Urol 1990;143(3):642-5.
17. Schonberger B. Verletzungen der mannlichen Gentitalorgane. Z Urol Nephrol 1982;75:879.
18. Nicoliasen GS, Melamud A, McAninch JW. Rupture of the corpus cavemosum : surgical management. J Urol 1983;917-9.
19. Ishikawa T, Fujisawa M, Tamada H. Fracture of the penis: nine cases with evaluation of reported cases in Japan. Int J Urol 2003;10:257-60.
20. Zargooshi J. Penile fracture in Kermanshah, Iran:report of 172 cases. J Urol 2000: 64:364-6.
21. Rodriguez Alonso A, Gonzalez Blanco A, Cespon Outeda E, Bonelli Martin C, Lorenzo Franco J, Cuerpo Perez MA, et al. Penile fracture. Report of a case. Actas Urol Esp 2001;25(10):765-9.
22. Miller S, McAninch JW. Penile fracture and soft tissue injury. In: McAninch JW, ed. Traumatic and Reconstructive Urology. Philadelphia: W.B. Saunders; 1996. p: 693-8.
23. Fegany AF, angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture Urology 1999;54:352-5.
24. Tiwary SK, Singh MK, Khanna R, Khanna AK. Penile fracture presenting as eggplant deformity. Kathmandy Univ Med J (KUMJ) 2006; 4(2):249-50.
25. Cumming J, Jenkins JD. Fracture of the corpora cavernosa and urethral rupture during sexual intercourse. Br J Urol 1991;67:327.
26. Kaladeniz T, Topsakal M, Ariman A. Penile fracture : differential diagnosis, management, and outcome. Br J Urol 1996;77:279-81.
27. Beysel M, Tekin A, Gurdal M. Evaluation and treatment of penile fractures : accuracy of clinical diagnosis and the value of corpus cavemosography. Urology 2002;60:492-6.
28. Pliskow RJ. Ohme RK. Corpus cavemoso graphy in acute ‘fracture’ of the penis. AJR Am J Roentgenol 1979; 133:331-2.
29. Fedel M, Venz S, Andreessen R. The value of magnetic resonance imaging in the diagnosis of suspected penile fracture. J Urol 1996;155:1924-7.
30. Feki W, Derouiche A, Belhaj K, Ouni A,Ben Mouelhi S,Ben Slama MR, et al. False penile fracture : report of 16 case. Int J Impot Res 2007;19(5):471-3.
31. Lorenzo Romero JG, Segura martin M, Salinas sanchez M, Pastor Guzman JM, Hernandez Millan I, Martinez Martin M, et al. Rupture of the corpora cavernosa : its therapeutic assessment and manage-ment. Actas Urol Esp 1999; 23(7):635-9.
32. Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR. Penile fracture: evaluation, therapeutic approach and long term results. J Urol 1996;155:148-9.
33. Uygur MC, Gulerkaya B, Altug B, Germiyanoglu C, Erol D.13 years experi¬ence of penile fracture. Scand J Urol Nephrol 1997; 31:265-6.
34. Mansi MK, Emran M, el-Mahrouky A, el-Mteet MS. Experience of penile fractures in Egypt: long-term results of immediate surgical repair. J Trauma 1993;35:67-70.
35. Agrawal SK, Morgan BE, Shafique M, Shazely M. Experience with penile fractures in Saudi Arabia. Br J Urol 1991;67(6):644-6.
36. Mellinger BC, Douenias R. New surgical approach for operative management of penile fracture and penetrating trauma. Urology 1992;39:429-32.
37. Su LM, Sutaria PM, Eid JF. Repair of penile rupture through a high- scrotal midline raphae incision. Urology 1998;52:717-9.
38. Konnak JW, Ohl DA. Microsurgical penile revascularization using the central corporeal penile artery. J Urol 1989; 142:305-8.
39. Pruthi RS, Petrus CD, Nidess R, Venable DD. Penile fracture of the proximal corporeal body. J Urol 2000;164:447-8.
40. Punekar SV, Kinne JS. Penile fracture. BJU Int 1999;84:183-4.
41. Kattan S, Youssef A, Onuora V, Patil M. Recurrent ipsilateral fracture of the penis. Injury 1993;24:685-6.
42. Nasser TA, and Mostafa T. Delayed surgical repair of penile frature under lacal anesthesia. J Sex Med 2008;5:2464-9.
2. Eke N. Fracture of the penis. Br J Surg 2002;89(5):555-65.
3. Klemen Jagodic, Marko Erklavec, Igor Bizjak, Sandi Poteko, Helena Korosec Jagodi. A case of penile fracture with complete urethral disruption during sexual intercourse : a case report. J Med Case Reports 2007;1:14.
4. Martinez RJ, Pastor Navarro H, Carrion Lopez P, Gimenez Bachs JM, Donate MM, Virseda Rodriguez JA. Fracture of the penis: a case series. Actas Urol Esp 2008;32(6):599-602.
5. Pandyan GV, Zaharani AB, A1 Rashid M. Fracture Penis: An Analysis of 26 cases. Scientific World Journal 2006;6:2327-33.
6. Bhuiyan ZH, Khan SA, Tawhid MH, Islam MF. Personal series with clinical review of fracture penis. Mymensingh Med J 2007;16(2):187-90.
7. Gregory S. Jack, Isla Garraway, Richard Reznichek, Jacob Rajfer. Current Treatment Options for Penile fractures. Rev Urol 2004;6(3):114-20.
8. El Atat R, Sfaxi M, Benslama MR, Amine D, Ayed M, Mouelli SB,et al. Fracture of the penis: management and long-term results of surgical treatment. Experience in 300 cases. J Trauma 2008;64(1):121-5.
9. Ghilan AM, Al-Asbahi WA, Ghafour MA, Alwan MA, Al-Khanbashi OM. Management of penile fractures. Saudi Med J 2008;29(10):1443-7.
10. Garcia Marchinena P, Capiel L, Juarez D, Liyo J, Giudice C, Gueglio G, Damia O. Penile fracture with associated urethra lesion : Case report and bibliographer review. Arch Esp Urol 2008;61(8):936-9.
11. Hanson GR, Thrasher JB. Urethral diverticalum as a sequela of unrepaired penile fracture. Can J Urol 2007;14(1):3461-2.
12. De Rose AF, Giglio M, Carmignani G. Traumatic rupture of the corpora cavernosa : new physiopathologic acquisitions. Urology 2001;57(2):319-22.
13. Mydlo JH. Surgeon experience with penile fracture. J Urol 200;166(2):526-9.
14. Mallis J. Zur Kausuistik der fractura penis. Arch Klin Chir 1924;129: 651.
15. Eke N. Fracture of the penis. Br J Surg 2001;89:555-65.
16. Bitsch M, Kromann-andersen B, Schou J, Sjontoft E. The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. J Urol 1990;143(3):642-5.
17. Schonberger B. Verletzungen der mannlichen Gentitalorgane. Z Urol Nephrol 1982;75:879.
18. Nicoliasen GS, Melamud A, McAninch JW. Rupture of the corpus cavemosum : surgical management. J Urol 1983;917-9.
19. Ishikawa T, Fujisawa M, Tamada H. Fracture of the penis: nine cases with evaluation of reported cases in Japan. Int J Urol 2003;10:257-60.
20. Zargooshi J. Penile fracture in Kermanshah, Iran:report of 172 cases. J Urol 2000: 64:364-6.
21. Rodriguez Alonso A, Gonzalez Blanco A, Cespon Outeda E, Bonelli Martin C, Lorenzo Franco J, Cuerpo Perez MA, et al. Penile fracture. Report of a case. Actas Urol Esp 2001;25(10):765-9.
22. Miller S, McAninch JW. Penile fracture and soft tissue injury. In: McAninch JW, ed. Traumatic and Reconstructive Urology. Philadelphia: W.B. Saunders; 1996. p: 693-8.
23. Fegany AF, angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture Urology 1999;54:352-5.
24. Tiwary SK, Singh MK, Khanna R, Khanna AK. Penile fracture presenting as eggplant deformity. Kathmandy Univ Med J (KUMJ) 2006; 4(2):249-50.
25. Cumming J, Jenkins JD. Fracture of the corpora cavernosa and urethral rupture during sexual intercourse. Br J Urol 1991;67:327.
26. Kaladeniz T, Topsakal M, Ariman A. Penile fracture : differential diagnosis, management, and outcome. Br J Urol 1996;77:279-81.
27. Beysel M, Tekin A, Gurdal M. Evaluation and treatment of penile fractures : accuracy of clinical diagnosis and the value of corpus cavemosography. Urology 2002;60:492-6.
28. Pliskow RJ. Ohme RK. Corpus cavemoso graphy in acute ‘fracture’ of the penis. AJR Am J Roentgenol 1979; 133:331-2.
29. Fedel M, Venz S, Andreessen R. The value of magnetic resonance imaging in the diagnosis of suspected penile fracture. J Urol 1996;155:1924-7.
30. Feki W, Derouiche A, Belhaj K, Ouni A,Ben Mouelhi S,Ben Slama MR, et al. False penile fracture : report of 16 case. Int J Impot Res 2007;19(5):471-3.
31. Lorenzo Romero JG, Segura martin M, Salinas sanchez M, Pastor Guzman JM, Hernandez Millan I, Martinez Martin M, et al. Rupture of the corpora cavernosa : its therapeutic assessment and manage-ment. Actas Urol Esp 1999; 23(7):635-9.
32. Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR. Penile fracture: evaluation, therapeutic approach and long term results. J Urol 1996;155:148-9.
33. Uygur MC, Gulerkaya B, Altug B, Germiyanoglu C, Erol D.13 years experi¬ence of penile fracture. Scand J Urol Nephrol 1997; 31:265-6.
34. Mansi MK, Emran M, el-Mahrouky A, el-Mteet MS. Experience of penile fractures in Egypt: long-term results of immediate surgical repair. J Trauma 1993;35:67-70.
35. Agrawal SK, Morgan BE, Shafique M, Shazely M. Experience with penile fractures in Saudi Arabia. Br J Urol 1991;67(6):644-6.
36. Mellinger BC, Douenias R. New surgical approach for operative management of penile fracture and penetrating trauma. Urology 1992;39:429-32.
37. Su LM, Sutaria PM, Eid JF. Repair of penile rupture through a high- scrotal midline raphae incision. Urology 1998;52:717-9.
38. Konnak JW, Ohl DA. Microsurgical penile revascularization using the central corporeal penile artery. J Urol 1989; 142:305-8.
39. Pruthi RS, Petrus CD, Nidess R, Venable DD. Penile fracture of the proximal corporeal body. J Urol 2000;164:447-8.
40. Punekar SV, Kinne JS. Penile fracture. BJU Int 1999;84:183-4.
41. Kattan S, Youssef A, Onuora V, Patil M. Recurrent ipsilateral fracture of the penis. Injury 1993;24:685-6.
42. Nasser TA, and Mostafa T. Delayed surgical repair of penile frature under lacal anesthesia. J Sex Med 2008;5:2464-9.