{"id":166,"title":"[Andrological aspects of urological trauma]","title_zh":"泌尿系创伤的男科相关后果：性腺功能、射精与勃起功能的诊治综述","url":"https://pubmed.ncbi.nlm.nih.gov/42980802","doi":"10.1007/s00120-026-02954-w","pmid":"42980802","journal":"Urologie","kind":"paper","lang":"en","published_at":"2026-11-04T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Anfosso M","Cremers JF"],"primary_topic":"male","topics":[{"slug":"male","score":9.0,"hits":["andrological","semen","sperm","spermatogenesis","testicular","testis"]},{"slug":"embryology-lab","score":1.0,"hits":["cryopreservation"]}],"topic_score":9.0,"preference_score":0.0,"preference_labels":[],"llm_score":61.0,"final_score":61.0,"score_dims":{"novelty":38,"rigor":35,"impact":45,"relevance":62,"translation":62},"recommend_reason":"主题贴近男性生育力保护与创伤后生殖健康管理，临床提示（保留睾丸手术、早期精子冻存、结构化随访）具有实用价值；但属叙述性综述、证据多来自小样本队列，方法学与创新性有限，适合快速浏览而非必读。","keywords":["泌尿生殖道创伤","男性生育力保护","精子冻存","射精障碍","勃起功能障碍","睾丸损伤"],"selected":1,"story_id":94,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-gametes","source_name":"PubMed · 配子与性腺","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"本文为叙述性综述，系统梳理泌尿生殖道创伤后的男科后果，包括睾丸功能、射精与勃起功能损害。文献提示，严重且双侧的睾丸损伤可能损害精子发生与睾酮生成，应尽量行保留睾丸手术，对高生育力丧失风险且有生育意愿者宜早期行精子冻存；射精障碍可表现为梗阻性、逆行射精或不射精；骨盆环骨折后勃起功能障碍发生率约37%，合并尿道损伤者风险更高。作者主张将男科评估纳入急性创伤救治，并通过激素检测、精液分析与性功能评估的结构化随访实现远期后遗症的早期发现与干预。","summary":"BACKGROUND: Andrological consequences of urogenital trauma receive limited attention. Available evidence is largely based on small cohorts. Testicular function, ejaculation, and erectile function may be affected. OBJECTIVE: To describe the effects of urological trauma on reproductive and sexual function and outline potential diagnostic and therapeutic measures. MATERIALS AND METHODS: Available literature on testicular dysfunction, ejaculatory disorders, and erectile dysfunction following urogenital trauma is summarized and interpreted in a clinical context. RESULTS: Severe and bilateral testicular injuries may impair spermatogenesis and testosterone production. Testis-sparing procedures should be preferred when feasible; early sperm cryopreservation should be considered in patients at high risk of fertility loss who wish to have children. Ejaculatory disorders include obstruction, retrograde ejaculation, and anejaculation. Erectile dysfunction occurs in approximately 37% of patients after pelvic ring fracture, with a higher risk in those with concomitant urethral injury. CONCLUSION: Andrological considerations should be integrated into acute trauma care. Structured follow-up, including hormonal assessment, semen analysis, and evaluation of sexual function, can facilitate early detection and treatment of long-term sequelae.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}