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Posttraumatic Posterior Urethral Strictures in Children: A 20-Year Experience

1997; Lippincott Williams & Wilkins; Volume: 157; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)65239-x

1527-3792

Mamdouh M. Koraitim,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyPediatric Urology1 Feb 1997Posttraumatic Posterior Urethral Strictures in Children: A 20-Year Experience Mamdouh M. Koraitim Mamdouh M. KoraitimMamdouh M. Koraitim View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65239-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We attempted to identify the particular features of strictures complicating pelvic fracture urethral injuries in children. Materials and Methods: A total of 68 boys 3 to 15 years old who had sustained pelvic fracture urethral disruption underwent 78 urethroplasties performed by bulboprostatic anastomosis through the perineum in 42, transpubically in 23 and by 2-stage urethroscrotal inlay in 13. Results: Perineal and transurethral urethroplasty was successful in 93 and 91% of cases respectively. There was a 54% failure rate after urethroscrotal inlay. Conclusions: Urethral strictures were most commonly associated with Malgaigne's fracture (35% of cases) and straddle fracture with or without diastasis of the sacroiliac joint (26%). Strictures were almost invariably inferior to the verumontanum with prostatic displacement in 44% of cases. Length of the strictured segment may be overestimated or underestimated on urethrography as a result of incomplete filling of the prostatic urethra or a urinoma cavity connected with the proximal segment, respectively. Perineal or transpubic bulboprostatic anastomosis is the best treatment for posttraumatic strictures, while internal urethrotomy should be avoided since it may compromise the chance of subsequent anastomotic urethroplasty. Repair of associated bladder neck incompetence may be deferred until the resumption of urethral voiding after urethroplasty, when incontinence can be documented. References 1 : Postpubertal genitourinary function following posterior urethral disruptions in children. 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Abstract, Google Scholar Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKulkarni S, Barbagli G, Kulkarni J, Romano G and Lazzeri M (2018) Posterior Urethral Stricture After Pelvic Fracture Urethral Distraction Defects in Developing and Developed Countries, and Choice of Surgical TechniqueJournal of Urology, VOL. 183, NO. 3, (1049-1054), Online publication date: 1-Mar-2010.Koraitim M (2018) Gapometry and Anterior Urethrometry in the Repair of Posterior Urethral DefectsJournal of Urology, VOL. 179, NO. 5, (1879-1881), Online publication date: 1-May-2008.Pratap A, Agrawal C, Tiwari A, Bhattarai B, Pandit R and Anchal N (2018) Complex Posterior Urethral Disruptions: Management by Combined Abdominal Transpubic Perineal UrethroplastyJournal of Urology, VOL. 175, NO. 5, (1751-1754), Online publication date: 1-May-2006.Zhang J, Xu Y, Qiao Y, Jin S, Wu D and Gu B (2018) An Evaluation of Surgical Approaches for Posterior Urethral Distraction Defects in BoysJournal of Urology, VOL. 176, NO. 1, (292-295), Online publication date: 1-Jul-2006.Pratap A, Agrawal C, Pandit R, Sapkota G and Anchal N (2018) Factors Contributing to a Successful Outcome of Combined Abdominal Transpubic Perineal Urethroplasty for Complex Posterior Urethral DisruptionsJournal of Urology, VOL. 176, NO. 6, (2514-2517), Online publication date: 1-Dec-2006.KORAITIM M (2018) ON THE ART OF ANASTOMOTIC POSTERIOR URETHROPLASTY: A 27-YEAR EXPERIENCEJournal of Urology, VOL. 173, NO. 1, (135-139), Online publication date: 1-Jan-2005.ROURKE K, McCAMMON K, SUMFEST J and JORDAN G (2018) Open Reconstruction of Pediatric and Adolescent Urethral Strictures: Long-term FollowupJournal of Urology, VOL. 169, NO. 5, (1818-1821), Online publication date: 1-May-2003.Koraitim M (2018) Re: Core-Through Urethrotomy Using The Neodymium:Yag Laser for Obliterative Urethral Strictures After Traumatic Urethral Disruption and/or Distraction Defects: Long-Term OutcomeJournal of Urology, VOL. 168, NO. 4 Part 1, (1507-1507), Online publication date: 1-Oct-2002.PODESTÁ M and JORDAN G (2018) PELVIC FRACTURE URETHRAL INJURIES IN GIRLSJournal of Urology, VOL. 165, NO. 5, (1660-1665), Online publication date: 1-May-2001.ISELIN C and WEBSTER G (2018) THE SIGNIFICANCE OF THE OPEN BLADDER NECK ASSOCIATED WITH PELVIC FRACTURE URETHRAL DISTRACTION DEFECTSJournal of Urology, VOL. 162, NO. 2, (347-351), Online publication date: 1-Aug-1999.KORAITIM M (2018) PELVIC FRACTURE URETHRAL INJURIES: THE UNRESOLVED CONTROVERSYJournal of Urology, VOL. 161, NO. 5, (1433-1441), Online publication date: 1-May-1999.PODESTA M (2018) USE OF THE PERINEAL AND PERINEAL-ABDOMINAL (TRANSPUBIC) APPROACH FOR DELAYED MANAGEMENT OF PELVIC FRACTURE URETHRAL OBLITERATIVE STRICTURES IN CHILDREN: LONG-TERM OUTCOMEJournal of Urology, VOL. 160, NO. 1, (160-164), Online publication date: 1-Jul-1998. Volume 157Issue 2February 1997Page: 641-645 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Mamdouh M. Koraitim More articles by this author Expand All Advertisement PDF downloadLoading ...