Role of visual internal urethrotomy in pediatric urethral strictures

Abstract

PurposeTo evaluate the efficiency of visual internal urethrotomies (VIUs) in pediatric patients. Patients and methodsThirty-four patients aged 0.2–16.3 years were treated with VIUs as a primary treatment for urethral stricture at our institution during 1980–2010. The stricture characteristics and need for repeat treatments as well as the results of repeat VIUs or dilatations were evaluated in a long-term follow-up. ResultsEach time first VIUs or repeat treatments were carried out there was a 22–33% success rate at 5 years. Twenty-four patients (71%) were treated successfully after repeat VIUs or dilatations at a median of 6.6 years' follow-up. None of the five patients with strictures longer than 2 cm were successfully treated, compared with 24 of 29 patients with shorter strictures (p = 0.001). However, stricture etiology or location did not have an impact on success. Currently four patients have undergone an open operation because of stricture and six patients are on a home dilatation program. ConclusionSingle VIU is successful for about one-quarter of pediatric patients with a urethral stricture. With repeated VIUs or dilatations 71% of the patients can achieve success. In strictures less than 2 cm, up to three VIUs can be attempted, but longer strictures need open correction if the patient does not wish to follow the home dilatation program.