AI Article Synopsis
- Pediatric urethral strictures in boys were studied to understand their causes and treatment outcomes over an 11-year period, excluding cases related to hypospadias repair.
- The most prevalent cause was trauma, particularly pelvic injury, with a notable 82% overall success rate for surgical interventions, although nearly half of the patients required redo surgeries.
- The study concluded that surgeries aimed to connect healthy urethra sections are often necessary due to the nature of the strictures, and the surgical approach depends on the stricture's location and severity.
Article Abstract
Background: Pediatric urethral stricture and its treatment have functional implications in the growing child.
Subjects And Methods: A retrospective study of records on urethral strictures encountered in our institution between January 2005 and May 2016 yielded 23 boys against a backdrop of 19,250 admissions during the same period; stenosis and strictures after hypospadias repair were not included in this study. Demographic data were collected from the charts, and the success of repair was assessed clinically by success of repair was assessed clinically by observing for presence or absence of symptoms such as dribbling, straining at voiding, adequacy of urinary stream and radiologicaly by assessing the micturition phase of voiding cystourethrogram. Success was defined as successful initiation, flow, and completion of voiding with radiological evidence of reestablishment of urethral continuity.
Results: The most common cause of urethral stricture was perineal or pelvic trauma (56.5%). Three after surgery for anorectal malformation (13.04%) and 2 (8.6%) followed otherwise unspecified urethritis. Transperineal and transpubic anastomotic routes were used for surgery. Redo surgery was required in 47.8%. The overall success rate was 82%. A self-catheterizable mitrofanoff channel was created as part of the primary procedure in 63.6% (7/11) or after the failure of the first procedure in 36.3% (4/11).
Conclusion: The majority of urethral strictures are long-segment strictures or those with complete disruption not amenable to endoscopic techniques. The aim of the surgery is to obtain end-to-end opposition of healthy proximal and distal urethra. The route - transperineal or transpubic - which will give the best access to the ends of the urethra is determined by the location and extent of the stricture and the alteration in anatomy as a consequence of the pelvic fracture. Even after the introduction of laser and endoscopic techniques, surgical repair is required to tackle the majority of urethral strictures in children.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182950 | PMC |
| http://dx.doi.org/10.4103/jiaps.JIAPS_146_17 | DOI Listing |
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