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[Urethral stenosis in children: treatment using urethroplasty with a vesical or oral mucosal graft]
G Monfort1, V Di Benedetto, B J Meyrat
1Service de Chirurgie, Hôpital de la Timone, Hôpital des Enfants, Marseille.
Insights
Pediatric urethral strictures, often congenital or post-traumatic, require precise diagnosis via imaging. Treatment varies from dilation and urethrotomy for limited cases to urethroplasty for complex strictures, achieving high success rates.
Area of Science:
- Pediatric urology
- Surgical reconstruction
- Urinary tract disorders
Context:
- Urethral strictures are uncommon in pediatric patients.
- Causes include congenital anomalies and iatrogenic injury from procedures like endoscopy.
- Accurate diagnosis is crucial for effective management.
Purpose:
- To outline diagnostic methods for pediatric urethral strictures.
- To describe treatment strategies based on stricture type and severity.
- To report outcomes of surgical interventions.
Summary:
- Diagnosis involves voiding cystometrography during urography or retrograde urethrography.
- Congenital membranes are treated with dilation; limited strictures with urethrotomy.
- Extensive strictures necessitate urethroplasty using mucosal grafts, with approximately 90% success.
Impact:
- Provides a management guideline for pediatric urethral strictures.
- Highlights the importance of tailored surgical approaches.
- Demonstrates the efficacy of reconstructive surgery in this population.
Abstract:
Urethral strictures are rare in children and correspond to either congenital membranes, post-traumatic (endoscopy). The precise diagnosis is obtained by voiding cystometrography at the end of urography or by retrograde opacification. Congenital membranes should be treated by dilatation and limited strictures should be treated by urethrotomy. The other cases warrant urethroplasty with a free vesical or oral mucosal flap. Good results are obtained in about 90% of cases.