TRANSPERINEAL ANASTOMOTIC URETHROPLASTY: EXPERIENCE IN PEDIATRIC & ADOLESCENT POPULATION VERSUS ADULT POPULATION

Abstract

fragility. We compared outcome of urethral reconstruction in the pediatric population as opposed to adults. METHODS: Between February 2002 and September 2005, 32 consecutive patients presenting with posterior urethral distraction defects, all caused by motor vehicle accidents, were included in our study. 16 pediatric patients with age range 5 and 17 years (mean 12.5) and 16 adult patients with age range 21 and 65 years (mean 40.2). We used the progressive perineal anastomotic repair in 29 patients. Two patients (an adult and a child) had extensive strictures of the bulbar and posterior urethra and were managed by substitutional urethroplasty. Scrotal inlay procedure was done in one adult patient also with extensive stricture of the bulbar and posterior urethra. RESULTS: Mean follow up was 16 months in the pediatric versus 28.5 months in the adult population. Results in both cohorts were found to be comparable. The primary and ultimate success rates were 81% and 87.5% in the pediatric population versus 69% and 100% in adults respectively. Other than re-stricture, one child had a bladder stone treated by cystolithotomy 6 months after surgery. No curvature, penile shortening or urethral diverticulae were noted during follow up. CONCLUSIONS: Comparable success could be achieved in pediatric and adult population with posterior urethral injuries. Open urethral reconstruction of adolescent and pediatric strictures provides excellent long-term results.