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[Junctional syndrome responsible for prostatic urethral dilatation: a new pathological entity?]
J L'Hermite1, A Six, M Schmitt
1Service d'urologie, CHR Nancy-Brabois, Vandoeuvre-les-Nancy.
Acta Urologica Belgica
|January 1, 1990
Summary
Monstrous prostatic urethral ectasia in boys can cause severe urinary retention. Surgical and minimally invasive treatments targeting the urethra successfully resolved symptoms and restored normal function.
Area of Science:
- Pediatric Urology
- Urethral Pathologies
- Functional Urology
Background:
- Monstrous ectasia of the prostatic urethra is a rare condition.
- Typically presents with severe urinary retention and dysuria in young boys.
- Etiology often relates to functional rather than organic obstruction.
Observation:
- Two cases of 12-year-old boys with no prior history presented with significant urinary retention (500ml and 1250ml).
- Initial investigations suggested potential vesico-sphincter dyssynergia or sphincter hypertension.
- Symptoms were attributed to intrinsic urethral functional disorders.
Findings:
- Case 1: Complex surgery involving urethral ectasia reduction and reimplantation achieved immediate complete bladder emptying and normalized flowmetry within six months.
- Case 2: Sub-montanal urethrotomy resulted in complete bladder emptying within ten months.
- Both patients maintained functional recovery at nine and two years post-treatment.
Implications:
- Successful treatment outcomes suggest intrinsic urethral pathology as a primary cause.
- Urethral-focused treatments can effectively manage severe prostatic urethral ectasia.
- Preservation of the striated sphincter is crucial for successful functional recovery.