Domínguez Hinarejos C, Bonillo García M A, Alapont Alacreu J M, Serrano Durbá A, Estornell Moragues F, García Ibarra F
Servicio de Urología Infantil, Hospital Universitario La Fe, Valencia.
Actas Urol Esp. 2007 Jan;31(1):29-32. doi: 10.1016/s0210-4806(07)73590-8.
[corrected] To review urethrorrhagia cases, the need of complementary test, its management and natural history.
A retrospective analysis was carried out for the 12 patients who suffered from urethrorrhagia, consecutively diagnosed in our department. Parameters as age, and micturitional habit were evaluated. In this way, we described the diagnostic techniques used, assessment and the follow-up of each patient.
All cases correspond to male children with an average age of 8.7 years (range: 18 months-14 years). Urethrorrhagia appears in 100% of the patients, episodes which were daily in 58.4%. 33% (4/12) of them also present other micturitional symptoms. 75% (9/12) had a lazy micturitional habit. Among the urological backgrounds we found: 1 patient was circumcised 3 years ago, a meatotomy was done in other due to meatus stenosis 2 years before, and a last one had an electrocoagulation of a urethral polyp just 1 month before. 83.4% (10/12) of urine cultures were negative. An urethrocystoscope was done in 9 patients finding a verum hypertrophy in 4, inflammatory changes next to membranous urethra in 3, scar at the bulbar urethra in 1 and in a last one no abnormalities were found. Out of 8 patients with lazy micturitional habit, 75% (6/8) resolve spontaneously once they correct their habits after a mean follow-up of 9 months. Only 2 patients needed surgery (TUR). In the other 2 patient, symptoms.
Urethrorrhagia in childhood is a benign condition in most cases, which is almost always cured spontaneously during the first 2 years of follow-up. Radiological studies as well as endoscopic procedures are unnecessary in the early management of these patients thus being relegated to recurrent or persistent bleeding.
回顾尿道出血病例、辅助检查的必要性、其治疗及自然病程。
对我科连续诊断的12例尿道出血患者进行回顾性分析。评估年龄、排尿习惯等参数。通过这种方式，我们描述了所使用的诊断技术、对每位患者的评估及随访情况。
所有病例均为男童，平均年龄8.7岁（范围：18个月至14岁）。100%的患者出现尿道出血，58.4%的患者出血为每日发作。其中33%（4/12）还存在其他排尿症状。75%（9/12）有排尿习惯不良。在泌尿外科病史方面，我们发现：1例患者3年前行包皮环切术，另1例因尿道口狭窄2年前行尿道口切开术，最后1例1个月前行尿道息肉电凝术。83.4%（10/12）的尿培养结果为阴性。9例患者行尿道膀胱镜检查，4例发现真性肥大，3例在膜部尿道旁有炎症改变，1例在球部尿道有瘢痕，最后1例未发现异常。在8例排尿习惯不良的患者中，75%（6/8）在平均随访9个月纠正习惯后症状自发缓解。仅2例患者需要手术（经尿道切除术）。另外2例患者有症状。
儿童期尿道出血在大多数情况下是一种良性疾病，几乎总是在随访的前2年内自发治愈。在这些患者的早期管理中，放射学检查及内镜检查并无必要，因此仅用于复发性或持续性出血情况。
