Ten cases of congenital urethral stricture in childhood with enuresis

Abstract

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.

Congenital anomalies of the male urethra

“…These might be secondary to a failure of canalization of the cloacal membrane during fetal development [1, 20] and have also been referred to as Cobb’s collar, Moormann’s ring and Young’s type III valve [7, 19]. Patients present with urinary tract infection.…”

“…10). Vesicoureteral reflux can be seen in up to 53% of patients [20]. Treatment is by transurethral incision.…”

Comparison of Heineke Mikulicz Stricturoplasty and End to End Anastomotic Urethroplasty Techniques for Short Bulbar Urethral Strictures

“…Bu bölgedeki kısa segment darlıklar ürogenital membranın tam kanalizasyonunun yetersizliği sebebiyle konjenital olabilmektedir. 14,15 Literatürün aksine, çalışmamızda 20 hastanın sadece beşinde bulbar üretra darlığının idiyopatik olduğu belirlenmiştir.…”

Cobb's collar: a rare cause of urinary retention

“…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. In adulthood, these patients may manifest poor ejaculation 7.…”