Etiology and characteristics of pediatric urethral strictures in a developing country in the 21st century

Ansari, M.S.; Yadav, Priyank; Srivastava, Aneesh; Kapoor, Rakesh; Shekar, P. Ashwin

doi:10.1016/j.jpurol.2019.05.020

Cited by 13 publications

(14 citation statements)

References 29 publications

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“…2019; 10(4):e88802. in agreement with previous studies, the number of the boys with urethral strictures was 9.9 times higher than the number of the girls (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In this population study, 86.2% of surgical treatments for urethral strictures in children were at the age between 1 to 10 years old.…”

Section: Discussionsupporting

confidence: 92%

“…The challenging conditions urethral stricture in children is a common disease (12) that surgery is recommended as the basis of management in most cases (1). Data about the etiology and clinical history of urethral stricture in children are extrapolated from adult series, and practical facts about this object seem scarce (12). Urethral stricture disease can be caused by iatrogenic, congenital, traumatic, inflammatory or idiopathic etiologies.…”

Section: Discussionmentioning

confidence: 99%

“…This decrease in caliber leads to diminished urinary stream and strenuous voiding, which further causes cracking of the meatal edges and meatitis, resulting in dysuria and this vicious circle continues. In the pediatric population, over time, meatotomy has developed as an optimistic procedure that is often done under local anesthesia with or without penile block or under short general anesthesia (12).…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Survey of Pediatric Urethral Stricture in Isfahan, Iran

2019

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Background: In order to ensure maximum recovery, stenosis management of the narrow and fragile tissue of urethra in children should be based on ingenious preserving of adequate urethral caliber. Objectives: Owing to advancements in pediatric surgery that lead to improving the quality and quantity of life in recent years, it is necessary to evaluate urethral strictures and its management. With this respect, we studied the management of children with urethral strictures in two tertiary hospitals in Isfahan, Iran. Methods: After obtaining ethical committee clearance (code number 396454), a retrospective search of the hospital information system was carried out for urethral stricture in children aged up to 15 years from 2008 to 2018. We studied all children who underwent the management for urethral strictures associated with recorded data (ICD-10; n = 35.9). Data were analyzed by SPSS and age, as a continuous variable, was expressed as mean ± standard deviation (SD). A P value of < 0.05 was considered statistically significant. Results: For over a period of 10 years, there were 383 children, including 348 boys and 35 girls, with the mean ± SD age of 5.5 ± 3.4 years old. The management strategies for boys with the disease of urethra ranked as: dilation of urethra (n = 99), urethral meatotomy (n = 82), urethral meatoplasty (n = 75), urethrotomy (n = 7) and unspecified management (n = 85). In girls, the ranked values corresponded to dilation of urethra (n = 14), diagnostic ureteroscopy (n = 7), and unspecified management (n = 12). There was a significant difference associated with age in each subgroup. Statistical analysis based on the Kruskal-Wallis test showed a significant difference between the variables (P < 0.0001). The minimum age for urethrotomy in the population studied was 4 years old. Conclusions: In pediatric, surgical treatment is an optimistic surrogate transaction to take the majority of cases with urethral strictures. As a result, in order to decrease complications such as incontinence, impotency, and surgical risks associated with major reconstructive procedures, proper repair at the appropriate time is recommended.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Retrospective Survey of Pediatric Urethral Stricture in Isfahan, Iran

2019

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“…Although urethral strictures can be traced back to ancient times [ 1 ], here is still a poor understanding of this disease. According to recent data, 193–627 out of 100,000 men suffer from urethral strictures [ 2 ], with the morbidity and etiology of this disease varying greatly between different countries and regions [ 3 , 4 ]. Trauma (51.67%), iatrogenic causes (34.49%), infection or inflammation (5.79%), and lichen sclerosus (4.22%) are the main etiologies of male urethral strictures [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of anterior urethral strictures in China: an internet-based survey

Chao-zhen

Yuan

et al. 2021

BMC Urol

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Background To investigate the current diagnostic and therapeutic approaches to anterior urethral strictures of Chinese urologists and to compare with developed countries and the American Urologic Association guidelines. Methods Anonymous questionnaires were distributed to members of Official Wechat Account of urology from March 19, 2020 to April 10, 2020. Descriptive and multiple correspondence analysis were used to analyze the data. Results A total of 1276 online questionnaires were received. The response rate was 21.7% (1276/5878). The most common diagnostic methods for anterior urethral stricture were urethrography (90.7%) and urethrocystoscopy (85.4%), while urethral dilation (92.3%) and internal urethrotomy (60.1%) were the main therapeutic procedures. End-to-end urethroplasty (45.2%) was the most common open surgery, followed by skin flap urethroplasty (14.9%) and free graft urethroplasty (12.4%). 76.2% of urologists used urethroplasty only after the failure of minimally invasive surgery (reconstructive ladder treatment strategy). Furthermore, middle-aged or elderly urologists who had attended trainings, had senior practice roles, and who utilized a reconstructive ladder treatment approach were most likely to perform urethroplasties. Conclusions Anterior urethral stricture treatment in China is still dominated by minimally invasive surgery, with most urologists using the reconstructive ladder treatment strategy. In general, the overall diagnostic and therapeutic strategies were similar between China and developed countries, with some deviations from the American Urologic Association guidelines.

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“…Although urethral strictures can be traced back to ancient times [1], here is still a poor understanding of this disease. According to recent data, 193-627 out of 100,000 men suffer from urethral strictures [2], with the morbidity and etiology of this disease varying greatly between different countries and regions [3,4]. Trauma (51.67%), iatrogenic causes (34.49%), infection or in ammation (5.79%), and lichen sclerosus (4.22% are the main etiologies of male urethral strictures [4].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Anterior Urethral Strictures in China: An Internet-Based Survey

Chao-zhen

Yuan

et al. 2021

Preprint

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Background To investigate the current diagnostic and therapeutic approaches to anterior urethral strictures of Chinese urologists and to compare with developed countries and the American Urologic Association guidelines. Methods Anonymous questionnaires were distributed to members of Official Wechat Account of urology from March 19, 2020 to April 10, 2020. Descriptive and multiple correspondence analysis were used to analyze the data. Results A total of 1276 online questionnaires were received. The response rate was 21.7% (1276/5878). The most common diagnostic methods for anterior urethral stricture were urethrography (90.7%) and urethrocystoscopy (85.4%), while urethral dilation (92.3%) and internal urethrotomy (60.1%) were the main therapeutic procedures. End-to-end urethroplasty (45.2%) was the most common open surgery, followed by skin flap urethroplasty (14.9%) and free graft urethroplasty (12.4%). 76.2% of urologists used urethroplasty only after the failure of minimally invasive surgery (reconstructive ladder treatment strategy). Furthermore, there were significant differences in age (P < 0.01), practice role (P < 0.01), hospital location (P < 0.01), treatment strategy (P < 0.01), management (P < 0.01), and number of urethroplasties (P < 0.01) between urologists who had attended training or not. Middle-aged or elderly urologists who had attended trainings, had senior practice roles, and who utilized a reconstructive ladder treatment approach were most likely to perform urethroplasties. Conclusions Anterior urethral stricture treatment in China is still dominated by minimally invasive surgery, with most urologists using the reconstructive ladder treatment strategy. In general, the overall diagnostic and therapeutic strategies for anterior urethral strictures were similar between China and developed countries, with some deviations from the American Urologic Association guidelines.

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Etiology and characteristics of pediatric urethral strictures in a developing country in the 21st century

Cited by 13 publications

References 29 publications

A Retrospective Survey of Pediatric Urethral Stricture in Isfahan, Iran

A Retrospective Survey of Pediatric Urethral Stricture in Isfahan, Iran

Diagnosis and treatment of anterior urethral strictures in China: an internet-based survey

Diagnosis and Treatment of Anterior Urethral Strictures in China: An Internet-Based Survey

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