Management of bulbar strictures in boys following previous endoscopic treatment of posterior urethral valves.

IF 2 3区 医学 Q2 PEDIATRICS Journal of Pediatric Urology Pub Date : 2024-11-22 DOI:10.1016/j.jpurol.2024.11.007
S M Norton, P M Joshi, S Bhadranawar, S B Kulkarni
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Abstract

Introduction: Urethral strictures following endoscopic management of Posterior Urethral Valves (PUV) varies from 0 % to 25 % and occurs due to iatrogenic injury of the urethra.

Objectives: To assess the outcomes of children undergoing urethral reconstruction following an iatrogenic injury during endoscopic management of PUV.

Methods: A retrospective review of a prospectively maintained database from 2015 to 2023 was undertaken of children who were referred following an iatrogenic injury to the urethra from prior endoscopic management of PUV.

Results: Seven boys with a history of PUV were referred following an iatrogenic bulbar urethral injury. All presented by age 2 and all had multiple attempted dilatations performed in external institutions. Two patients had also undergone an anastomotic urethroplasty with subsequent failure and recurrence of the stricture in the bulbar urethra, to a near obliterative state. The 5 patients who had no prior attempted urethroplasty, underwent a dorsal onlay. The 2 patients who had an attempted anastomotic urethroplasty with subsequent failure, both presented with bulbar necrosis. A pedicled preputial flap was used for both patients for reconstruction.

Conclusion: Iatrogenic injury of the urethra can occur during endoscopic ablation of PUV. Urethroplasty is successful and best performed with a preputial skin graft if available.

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男孩后尿道瓣膜内镜治疗后球囊狭窄的处理。
导读:后尿道瓣膜(PUV)内窥镜治疗后尿道狭窄的发生率从0%到25%不等,是由尿道的医源性损伤引起的。目的:评估儿童在内窥镜治疗PUV时医源性损伤后进行尿道重建的结果。方法:对2015年至2023年的前瞻性维护数据库进行回顾性分析,这些数据来自于既往内窥镜治疗尿道损伤后转诊的儿童。结果:7名有PUV病史的男孩在医源性球尿道损伤后转诊。所有患者均在2岁时出现,均在外部机构多次尝试扩张。两名患者也接受了吻合尿道成形术,随后尿道球部狭窄复发,接近闭塞状态。5例患者之前没有尝试过尿道成形术,接受了背侧移植。2例患者行吻合口尿道成形术失败,均表现为球囊坏死。两例患者均采用带蒂包皮皮瓣重建。结论:尿道内窥镜消融术可引起尿道医源性损伤。尿道成形术是成功的,如果可用,最好使用包皮移植。
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来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
期刊最新文献
Letter to the editors on "International consensus on research priorities in hypospadias using a Delphi study approach". The influence of positive and negative intraoperative feedback in laparoscopic simulation in pediatric urology training. Alkaline urine is associated with increased risk of calcium phosphate nephrolithiasis in medically complex children receiving enteral nutrition. The utilization of a spare ureter to create a continent catheterizable channel to the bladder in pediatric patients. Response to the editorial commentary on 'When you cannot trust what you see: The confounding effect'.
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