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[Endoscopic treatment of urethral stenoses in children]
R Gosálbez1, J A Martín Osorio, C Piró
1Fundación Puigvert y Clínica de la Generalitat, Clínica Infantil de la Generalitat, Barcelona.
Insights
Endoscopic surgery effectively treated urethral stenosis in 29 male children. While 72% had good outcomes, 38% needed repeat operations, with congenital cases faring best.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Urethral Reconstruction
Background:
- Urethral stenosis in male children presents a significant surgical challenge.
- Etiologies include trauma and congenital anomalies, impacting treatment strategies.
- Endoscopic approaches offer minimally invasive options for urethral strictures.
Observation:
- Twenty-nine male pediatric patients (7 months–18 years) with urethral stenosis underwent endoscopic surgery.
- Trauma was the primary cause (21 cases), followed by congenital factors (8 cases).
- Stenosis locations varied, with the membranous urethra being most common (18 cases).
Findings:
- Endoscopic urethrotomy and resection achieved good results in 72% of cases.
- A notable 38% required multiple surgical interventions.
- Congenital stenosis demonstrated superior outcomes compared to post-traumatic or complex cases.
Implications:
- Endoscopic surgery is a viable treatment for pediatric urethral stenosis, particularly congenital types.
- Recurrence rates necessitate careful patient selection and follow-up.
- Further research into optimizing surgical techniques for complex or traumatic strictures is warranted.
Abstract:
Twenty-nine male children with urethral stenosis, with ages between 7 months and 18 years, were treated by endoscopic surgery. The etiology of their condition was trauma in 21 cases and congenital in 8. Location of the stenosis corresponded in 18 cases to membranous urethra, 7 to bulbar urethra, 2 to penial urethra while 2 were double, membranous and bulbar. The magnitude of the stenosis was under 1 cm in 24 cases, between 1 to 2 cm in 4 cases and over 2 cm in 1 case. Treatment carried out was visually controlled endoscopic urethrotomy and endoscopic resection. The results obtained were rated as good in 21 children (72%), but 38% required more than one operation. The best results corresponded to the so-called congenital stenosis and the worse to those secondary to rectal atresia and urethral valves.