Anterior Urethral Strictures in Children: Disease Etiology and Comparative Effectiveness of Endoscopic Treatment vs. Open Surgical Reconstruction

Frontiers in Pediatrics
Malte W VetterleinMargit Fisch

Abstract

Pediatric anterior urethral strictures are rare and recommendations regarding treatment strategies derive from small monocentric case series. In 2014, a collaborative effort of the Société Internationale d'Urologie and the International Consultation on Urological Diseases drafted the first systematic and evidence-based guideline for diagnosis and treatment of urethral strictures in children. Against this backdrop, we performed an updated literature review to provide a comprehensive summary of the available evidence and contemporary outcomes with a focus on comparative effectiveness of endoscopic treatment (dilation or urethrotomy) vs. open surgical reconstruction. Overall, 22 articles reporting on children with anterior urethral strictures were included into the review. Most strictures were iatrogenic (48%) and traumatic (34%), whereas congenital (13%), inflammatory (4%), or postinfectious strictures (1%) were rather rare. The cumulative success rate of endoscopic treatment and urethroplasty was 46% (range: 21-75; N = 334) and 84% (range: 25-100; N = 347), respectively. After stratifying patients according to urethroplasty technique, success rates were 82% (range: 25-100; N = 206) for excision and primary anastomosis, 94% (rang...Continue Reading

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Citations

Oct 22, 2020·Case Reports in Urology·Kwaku Addai Arhin AppiahAugustina Badu-Peprah

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