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Updated: Jul 1, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Pediatric and adolescent transperineal anastomotic urethroplasty
M G El-Sheikh1, A M Ziada, S Z Sadek
1Urology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
Open reconstructive surgery for pediatric urethral strictures offers durable, long-term success. This study highlights the effectiveness of urethroplasty in young patients with posterior urethral injuries, recommending it as a primary treatment.
Area of Science:
- Pediatric Urology
- Reconstructive Surgery
- Trauma Surgery
Background:
- Pediatric urethral strictures pose surgical challenges due to anatomical differences.
- Limited data exists on reconstructive outcomes in pediatric urethral injuries.
Purpose of the Study:
- To evaluate the outcomes of open reconstructive techniques for pediatric and adolescent posterior urethral distraction injuries.
Main Methods:
- A cohort of 15 pediatric patients (age 5-17) with posterior urethral distraction defects underwent open reconstruction.
- A progressive perineal approach was utilized to achieve tension-free spatulated anastomosis.
- Data was collected between February 2002 and September 2005.
Main Results:
- Mean follow-up was 28.4 months.
- Initial and ultimate success rates were 80% and 86.6%, respectively.
- No significant complications like penile shortening or diverticulae were observed; one patient developed a bladder stone.
Conclusions:
- Modern urethroplasty guidelines ensure consistent success in pediatric posterior urethral injuries.
- Open urethral reconstruction provides excellent long-term results with minimal morbidity in pediatric patients.
- Urethral reconstruction is recommended as the primary treatment for pediatric urethral strictures due to repair durability.
Purpose:
Pediatric urethral stricture disease represents a significant surgical challenge because of smaller pelvic confines, decreased caliber and increased tissue fragility. Operative series of pediatric urethral reconstruction usually involve small numbers. In this study, we examined the outcome of open reconstructive techniques for pediatric and adolescent patients with posterior urethral distraction injuries.
Patients And Methods:
Between February 2002 and September 2005, 15 patients from Kasr ElAini hospital presenting with posterior urethral distraction defects due to motor vehicle accidents were included in our study. Their age ranged between 5 and 17 years (mean 12.5). We used the progressive perineal approach to achieve a tension-free spatulated anastomosis.
Results:
Mean follow-up was 28.4 months. Initial and ultimate success rates were 80 and 86.6%, respectively. Other than re-stricture, one child had a bladder stone treated by cystolithotomy 6 months after surgery. No penile curvature, shortening or urethral diverticulae were noted during follow-up.
Conclusion:
Using the appropriate modern guidelines of urethroplasty, consistent success can be achieved in pediatric and adolescent patients with posterior urethral injuries. Open urethral reconstruction of adolescent and pediatric strictures provides excellent long-term results with minimal morbidity. Urethral reconstruction is strongly recommended as the primary treatment option, especially in the pediatric urethral stricture population, because of the repair durability.
