Impact of Congenital Narrowing of the Bulbar Urethra (Cobb&amp;rsquo;s Collar) andIts Transurethral Incision in Children

Nonomura, Katsuya; Kuriyama, Takayuki; Κakizaki, Hidehiro; Koyama, Toshiki; Yamashita, Tetsufumi; Koyanagi, Tomohiko

doi:10.1159/000067986

Cited by 24 publications

(17 citation statements)

References 17 publications

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“…According to 74 cases reported by Nonomura et al . urinary tract infection (UTI) was most common symptom, VUR occurred in 53% cases 11 . They also reported that VUR, UTI and enuresis were resolved or improved by the internal urethrotomy in almost all cases.…”

Section: Discussionmentioning

confidence: 96%

Ten cases of congenital urethral stricture in childhood with enuresis

et al. 2005

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Background : To report short-term clinical outcomes of endoscopic correction of congenital urethral stricture in 10 boys who suffer from enuresis resistant to conservative therapy. Methods : Fifteen boys ranging between 5 and 15 years old consulted our clinics for nocturnal and diurnal enuresis which had not been improved by medication and behavioral therapy. Among them, voiding cystography revealed bulbar narrowing (Cobb's Collar) in 10 cases and vesico-ureteral reflux was found in four cases (seven ureters). Endoscopically, this lesion was recognized as a ring-form stenosis just distal to the urethral sphincter. It was incised with infantile urethrotome.Results : Vesico-ureteral reflux was resolved in four ureters and improved in one. In all cases, daytime enuresis resolved dramatically and night enuresis became controllable. Conclusions : Boys who suffer from diurnal enuresis should immediately be explored for the existence of congenital urethral stenosis. Early resolution may bring about better urinary behavior.

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Section: Discussionmentioning

confidence: 96%

Ten cases of congenital urethral stricture in childhood with enuresis

et al. 2005

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“…Recently, Dewan et al redefined and classified the bulbar urethral narrowing by reviewing video-recorded cystoscopies as well as radiological pictures of their patients. A similar study was also performed by Nonomura et al 5 6. Both studies showed that the majority of patients with congenital bulbar urethra obstruction were under 1 year of age and had no history of trauma, catheterisation or instrumentation of the urethra.…”

Section: Discussionmentioning

confidence: 52%

“…Cobb's collar in fact appears as a bulbar urethral obstruction which is independent from the verumontanum and external sphincter, being caused by a persistence of urogenital membrane 8. Clinical presentation of a urethral obstruction in the bulbar tract may be variable and, often, the real problem remains hidden to the use of a blind instrumentation such as urethral catheterisation due to facility of dilation of these strictures 6. Cobb's collar may occasionally lead to chronic urinary retention and bilateral hydronephrosis 11.…”

Section: Discussionmentioning

confidence: 99%

Cobb's collar: a rare cause of urinary retention

2013

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Cobb's collar is a membranous stricture of the bulbar urethra, often misdiagnosed, potentially leading to acute urinary retention, upper urinary tract dilations, enuresis, infectious diseases, poor streaming and haematuria. A 14-year-old boy with a history of previous hospitalisations came to our attention. A Cobb's collar was diagnosed and successfully managed with a videoendoscopic one-step approach. Although extremely uncommon, paediatric urologists must be aware of this congenital anomaly. A correct and timely diagnosis and endoscopic management may affect positively the clinical onset of these patients avoiding major urethral surgery and preserving renal and bladder function.

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“…[6] and later Nonomura et al . [7] redefined and classified the bulbar urethral narrowing by reviewing video-recorded cystoscopies as well as radiological pictures in the patients. Both studies showed that the majority of patients were below 1 year of age with a large number showing vesicoureteral reflux (VUR), with no history of urethral trauma, catheterization, or instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Cobb′s collar occurring in two brothers in a family: A rare entity revisited

Pal

Ray

Talukdar

et al. 2014

Indian Journal of Radiology and Imaging

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Most urethral strictures arise from iatrogenic, traumatic, or inflammatory causes. We report the familial occurrence of a congenital bulbar urethral stricture in two brothers. Retrograde and voiding cystourethrography was performed. A Cobb's collar was diagnosed after radiological and endoscopic evaluation in both cases and was successfully managed with urethroplasty. Cobb's collar is a rarely recognized cause of a membranous stricture of bulbar urethra that can lead to several urinary problems. In cases of adolescent and young adults presenting with symptoms of progressive urinary obstruction and enuresis with or without urinary tract infection, Cobb's collar can be seen as a minor constriction in the bulbar urethra, but is not frequently symptomatic, and the familial occurrence of such a stricture is even rarer.

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Impact of Congenital Narrowing of the Bulbar Urethra (Cobb’s Collar) andIts Transurethral Incision in Children

Cited by 24 publications

References 17 publications

Ten cases of congenital urethral stricture in childhood with enuresis

Ten cases of congenital urethral stricture in childhood with enuresis

Cobb's collar: a rare cause of urinary retention

Cobb′s collar occurring in two brothers in a family: A rare entity revisited

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