Post-traumatic Posterior Urethral Strictures In Children-Management And Intermediate-term Follow-up In Tertiary Care Center

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 28 Sep 2008 - 0:00 PDT

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UroToday.com - A study by Dr. Manish Singla out of India evaluated the management and intermediate-term follow-up of posttraumatic posterior urethral strictures in children. The study took place over a 6-year time-frame, and included 28 children who had been admitted for treatment of posttraumatic posterior urethral strictures. The cohort was reviewed retrospectively. The median follow-up period was 36 months, with a range of 3-58 months.

The mean age of the patients at the time of injury was 12.1 years. The estimated stricture length, radiographically identified before surgery, was 3.41 cm. Of the 28 patients, 27 of them were treated with a transperineal anastomotic urethroplasty and spatulation. This resulted in a success rate of 75%. All treatment failure was at the anastomotic site and occurred within the first year of urethroplasty. All of the failed repairs were successfully managed endoscopically in 4 patients and by redo urethroplasty in 3 patients for a final success rate of 100%. With urethral manipulation before anastomotic urethroplasty, 15 of the 28 patients (80%) had a satisfactory result compared with 69.3% of patients without previous surgical treatment. However, the difference was not statistically significant.

The group concluded that posttraumatic posterior urethral strictures in children can be managed through the perineal route. They also felt that previous urethral manipulations did not affect their outcomes.

Singla M, Jha MS, Muruganandam K, Srivastava A, Ansari MS, Mandhani A, Dubey D, Kapoor R.

Urology. 2008 Jul 9. Epub ahead of print.
doi:10.1016/j.urology.2008.02.078

Written by UroToday.com Medical Editor Pasquale Casale, MD

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