Stricture Urethra in Children: An Indian Perspective

Area of Science:

• Pediatric Urology
• Surgical Reconstruction
• Urethral Stricture Management

Background:

• Pediatric urethral stricture poses significant functional challenges in growing children.
• Trauma is a leading cause of urethral strictures in pediatric patients.
• Endoscopic techniques are often insufficient for complex pediatric urethral strictures.

Purpose of the Study:

• To evaluate the causes, surgical outcomes, and management strategies for pediatric urethral strictures.
• To assess the success rates of surgical repair for urethral strictures in children.
• To determine the optimal surgical approach for pediatric urethral strictures based on location and extent.

Main Methods:

• Retrospective analysis of 23 pediatric urethral stricture cases (excluding hypospadias-related strictures) from January 2005 to May 2016.
• Clinical assessment included symptom evaluation (dribbling, straining, stream adequacy).
• Radiological assessment utilized voiding cystourethrogram (VCUG) to confirm urethral continuity and function.

Main Results:

• Perineal or pelvic trauma accounted for 56.5% of cases.
• Overall surgical success rate was 82%, with 47.8% requiring redo surgery.
• A self-catheterizable Mitrofanoff channel was created in 63.6% of primary procedures or 36.3% after initial failure.

Conclusions:

• Surgical repair remains essential for the majority of pediatric urethral strictures, particularly long-segment or completely disrupted cases.
• Transperineal or transpubic approaches are selected based on stricture location, extent, and associated anatomical alterations.
• Reconstructive surgery aims for end-to-end urethral opposition to restore normal voiding function.