Construction of a neourethra in girls: follow-up results

Female urethral injuries may cause serious morbidity with loss of the entire urethra in some cases. We review the results of construction of a neourethra by the flipped anterior bladder-tube technique in five girls aged 3-18 years (mean 8 years). All had pelvic fractures and had their initial management elsewhere; four were run over by motor vehicles and one suffered a pelvic gunshot injury. Three patients came with a suprapubic cystostomy, one was totally incontinent, and another had a urethrovaginal fistula. Three had an associated vaginal injury. All five patients underwent construction of a neourethra using a flipped anterior bladder-wall tube (FABWT) and have been followed for 18-80 months (mean 44 months). All patients were continent in the daytime and three passed urine spontaneously. Two were managed by clean intermittent catheterization (CIC), one per urethram and other via a continent abdominal stoma (Mitrofanoff). The FABWT technique should be considered as an option in the management of females with severe urethral injury.