Urethral strictures in childhood

Area of Science:

• Pediatric Urology
• Surgical Procedures
• Urethral Strictures

Background:

• Non-hypospadiac urethral strictures are uncommon in children.
• Meatal stenosis can be associated with balanitis xerotica obliterans, often following circumcision.
• Proximal urethral strictures have diverse etiologies including catheterization, trauma, congenital factors, and idiopathic causes.

Purpose of the Study:

• To evaluate the treatment outcomes for non-hypospadiac urethral strictures in pediatric patients.
• To assess the efficacy of meatoplasty, meatal dilatation, and visual urethrotomy for different types of urethral strictures.

Main Methods:

• Retrospective analysis of 36 children treated for non-hypospadiac urethral strictures.
• Categorization of strictures into meatal/submeatal and proximal types.
• Surgical interventions included meatoplasty, meatal dilatation, visual urethrotomy, and urethroplasty.

Main Results:

• Meatoplasty or meatal dilatation were successful for 10 of 12 patients with meatal stenosis.
• Visual urethrotomy achieved success in 12 of 16 children with proximal strictures, with most requiring 1-2 procedures.
• Two children needed multiple urethrotomies, and two underwent urethroplasty for recurrent strictures. No complications were reported.

Conclusions:

• Meatoplasty and meatal dilatation are effective for meatal stenosis in children.
• Visual urethrotomy is a viable and successful treatment for many proximal urethral strictures, minimizing the need for open surgery.
• Urethroplasty remains an option for refractory cases, with good outcomes observed in this cohort.