Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India.

To evaluate the management and intermediate-term follow-up of posttraumatic posterior urethral strictures in children.

From March 2000 to November 2006, the surgical records of 28 children ( The mean age of the patients was 12.1 years (range 5-18) at the injury. The estimated radiographic mean stricture length before surgery was 3.41 cm (range 2-6). Of the 28 patients, 27 were treated with transperineal anastomotic urethroplasty, with a success rate of 75%. All treatment failures were at the anastomotic site and occurred within the first year of anastomotic urethroplasty. The failed repairs (7 cases) were successfully managed endoscopically in 4 patients and by redo urethroplasty in 3, for a final success rate of 100%. Of the 28 patients, 15 (80%) with urethral manipulation before anastomotic urethroplasty had a satisfactory result compared with 69.3% of patients without previous surgical treatment. The difference was not statistically significant.

Most posttraumatic posterior urethral strictures in children can be managed through the perineal route. The transpubic approach should be reserved for more complex posterior strictures. Previous urethral manipulations did not affect the intermediate-term results of anastomotic urethroplasty.

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

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

PubMed Abstract
PMID:18619659

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