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Dergiler / The Journal of Pediatric Research / 2021 / Cilt: 8 - Sayı: 4

Pediatric Urethral Strictures and Management Strategies; An Evolving and Learning Experience

Mir FAHİEM UL HASSAN
Vinay JADHAV
Narendrababu MUNİANJANAPPA
Murali SAROJA
Sayfa
444–450
DOI
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Yapay Zeka Hızlı Bakış & Çıkarımlar

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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

For longer bulbar strictures, substitution urethroplasties are viable alternatives.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Aim: Most of the surgical strategies for pediatric urethral strictures (PUS) are derived from adult experiences.
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Temel Bulgular & Veri:Owing to this, we carried out this study to assess the management strategies for PUS in our institute.
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Sonuç & Katkı:For longer bulbar strictures, substitution urethroplasties are viable alternatives.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Aim: Most of the surgical strategies for pediatric urethral strictures (PUS) are derived from adult experiences. Owing to this, we carried out this study to assess the management strategies for PUS in our institute. Materials and Methods: This prospective study included 28 patients with PUS. Preoperatively, patients were assessed clinically and were subjected to voiding cystourethrography (VCUG) and pre-procedure cystoscopy. Intraoperatively, urethroscopy, VCUG and retrograde urethrography were used to evaluate the length of the stricture. Urethral dilatation (UD), direct visualization and internal urethrotomy (DVIU), excision and primary anastomosis (EPA) with or without pubectomy and dorsal onlay urethroplasty (DOU) were the procedures instituted to treat the strictures. After the procedure, a silicone catheter was left in situ for 1-2 weeks in cases of DU or DVIU and 4-6 weeks in cases of EPA or DOU. Postoperatively, patients were assessed in terms of their symptoms and for VCUG/cystoscopic evidence of reestablishment of urethral continuity. There was an average follow-up period of 1.9 years. Results: Three patients were successfully treated with single session UD and another three with multiple sessions. Two UD patients required EPA. DVIU was performed in four patients. This procedure failed in one and so required EPA. EPA was carried out in fourteen patients with two requiring redo-EPA. Graft onlay urethroplasty was performed in five patients with satisfactory results. Conclusion: The procedure to address a stricture should be tailored to the individual urethral anatomy, stricture length and the surgeons’ experience. For smaller and partially obstructing strictures, DVIU and DU can be tried but these procedures seem to be less effective than EPA, with high rates of secondary procedures. However, if not accompanied by complete excision of fibrosed spongiosum, EPA may have to be repeated. For longer bulbar strictures, substitution urethroplasties are viable alternatives.

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Bu Makaleye Atıf Yap

HASSAN, M. F. U., JADHAV, V., MUNİANJANAPPA, N., SAROJA, M. (2021). Pediatric Urethral Strictures and Management Strategies; An Evolving and Learning Experience. The Journal of Pediatric Research, Cilt: 8 - Sayı: 4, 444–450. https://ajindex.com/articles/362866

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