Pediatric Urology Research Center, Department of Pediatric Urology, Children's Hospital Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
J Pediatr Surg. 2010 Nov;45(11):2217-21. doi: 10.1016/j.jpedsurg.2010.06.048.
The aim of the study was to evaluate the efficacy and safety of urethral hydrodistension for management of urethral hypoplasia in prune belly syndrome (PBS).
During a 10-year period, 7 infants with PBS and urethral hypoplasia presented either with open urachus or surgically created urinary diversion referred to our hospital. Five milliliters of normal saline was pushed via a 22-gauge plastic angiocatheter into the urethra with simultaneous finger pressure on the perineum to occlude the proximal urethra that was repeated with higher volumes of the solution (up to 20 mL). The procedure was continued until a 6F or 8F feeding tube catheter confirmed the urethral patency. Hydrodistension was repeated in 3-month intervals till complete patency was confirmed by imaging.
Median age of the infants was 6 (1-8) months. All urethral hydrodistension were successful after 1 to 3 sessions. Follow-up imaging studies showed significant improvement in all patients except one. Natural and surgically created urinary diversions were closed in 6 infants.
The hydrodistension create an equal and constant pressure into the urethral wall without any urethral damage. This technique can be considered along with the other available methods for management of urethral hypoplasia in selected cases of PBS.
本研究旨在评估尿道扩张术治疗脐膨出综合征（PBS）患者尿道下裂的疗效和安全性。
在 10 年期间，7 名患有 PBS 和尿道下裂的婴儿因开放性脐尿管或手术创建的尿流改道而被转诊至我院。通过 22 号塑料血管造影导管将 5 毫升生理盐水推入尿道，同时用手指按压会阴部以闭塞近端尿道，然后用更高体积的溶液（最高可达 20 毫升）重复该操作。该过程持续进行，直到 6F 或 8F 喂养管导管确认尿道通畅。每隔 3 个月重复进行尿道扩张术，直到通过影像学检查确认完全通畅。
婴儿的中位年龄为 6（1-8）个月。所有婴儿均在 1-3 次治疗后成功进行了尿道扩张术。随访影像学研究显示，除 1 名婴儿外，所有患者的情况均有显著改善。6 名婴儿的自然和手术创建的尿流改道均已关闭。
尿道扩张术在尿道壁上产生均匀且恒定的压力，而不会造成任何尿道损伤。对于 PBS 中特定情况下的尿道下裂，这种技术可以与其他可用的治疗方法一起考虑。
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