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Updated: Jun 25, 2026
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Published on: January 7, 2019
Aetiology and treatment of symptomatic idiopathic urethral strictures in children
F C L Banks1, S J Griffin, H A Steinbrecher
1Department of Paediatric Urology, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
Insights
Paediatric urethral strictures presenting in infancy often resolve with urethrotomy and dilatation. Older children may have different causes and require adult-like surgical treatment for better outcomes.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Congenital Abnormalities
Background:
- Urethral strictures in children can be challenging to manage.
- Congenital origins are often suspected but may be misattributed.
Purpose of the Study:
- To analyze the presentation and treatment outcomes of pediatric bulbar or posterior urethral strictures.
- To investigate the potential congenital origins of these strictures.
Main Methods:
- Retrospective case-note review of 12 pediatric urethral stricture cases.
- Cases were prospectively collected in a departmental database over 9 years.
Main Results:
- A bimodal age distribution was observed: 6/12 presented in the first year of life, 5/12 after age 11.
- Infants (under 1 year) had successful outcomes with urethrotomy and dilatation.
- Older children (over 11) often required urethroplasty, with one 3-year-old potentially needing future urethroplasty.
Conclusions:
- Older children may have different etiologies for urethral strictures than infants.
- Caution is advised when labeling strictures in ambulant children as congenital.
- Treatment for older children should align with adult surgical approaches for better long-term resolution.
Objective:
To report the presentation and treatment outcomes on a series of 12 paediatric bulbar or posterior urethral strictures that were possibly congenital in origin, identified in a 9-year period.
Methods:
A retrospective case-note review of all cases of urethral strictures thought to be congenital in origin, prospectively collected into the departmental database.
Results:
The age at presentation had a bimodal distribution with 6/12 presenting in the first year of life of which four had antenatal hydronephrosis and 5/12 presenting after the age of 11 years. All six patients under 1-year old had a successful outcome following urethrotomy and urethral dilatation. Four of five over 11 years of age ultimately required an urethroplasty and one 3-year-old may well require an urethroplasty in the future.
Conclusion:
This outcome, in conjunction with the bimodal age distribution at presentation, would suggest a different aetiology in older children, and we would urge caution in classifying strictures in ambulant children as genuinely congenital, as this population may represent the long-term manifestation of unrecorded bulbar urethral trauma or asymptomatic inflammation. Optical urethrotomy or dilatation is durable when treated in infancy, but older patients do not experience prolonged resolution and we would recommend treatment along adult lines for these.
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