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Pelvic Fracture Urethral Distraction Defects in Preschool Boys: How to Recognize and Manage?

Lin Wang1, Jiasheng Chen1, Rong Lv1

  • 1Department of Urology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, China.

Urology
|November 14, 2021
PubMed

Insights

Pelvic fracture urethral distraction defects (PFUDD) in young boys can be successfully treated with transperineal anastomotic urethroplasty. This technique achieved a 100% success rate in a small cohort, offering a promising solution for this challenging condition.

Area of Science:

  • Pediatric Urology
  • Trauma Surgery
  • Reconstructive Urology

Background:

  • Pelvic fracture urethral distraction defect (PFUDD) in preschool boys is a rare and challenging condition.
  • Management requires specialized surgical expertise to restore urethral continuity and function.

Purpose of the Study:

  • To report cases of PFUDD in preschool boys.
  • To evaluate the efficacy of transperineal anastomotic urethroplasty for treating PFUDD in this age group.

Main Methods:

  • Retrospective review of 8 preschool boys (<6 years) with PFUDD treated between 2010 and 2021.
  • All patients underwent transperineal anastomotic urethroplasty, with a minimum 3-month interval post-trauma or failed intervention.
  • One case involved combined urethroplasty and urethrorectal fistula repair.

Main Results:

  • A 100% success rate was achieved in all 8 patients, defined by restored urethral patency and continuity without further intervention.
  • No recurrence of stenosis or urinary fistulas were observed during a median follow-up of 65 months (range 3-135 months).
  • One patient experienced stress urinary incontinence during high-intensity exercise; potency could not be assessed due to age.

Conclusions:

  • Transperineal anastomotic urethroplasty is a highly effective strategy for managing PFUDD in preschool boys.
  • This approach offers a high success rate and favorable outcomes, addressing a significant challenge in pediatric reconstructive urology.
Abstract

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