University Hospital Hamburg-Eppendorf, Department of Urology, Martinistr. 52, 20246 Hamburg, Germany.
J Pediatr Urol. 2013 Dec;9(6 Pt A):769-74. doi: 10.1016/j.jpurol.2012.09.007. Epub 2012 Oct 13.
To evaluate the etiology of posterior and/or bulbar strictures in children in an industrialized country and assess the outcome of its repair by perineal approach. Urethral strictures in children are rare and often challenging to treat. Trauma is the main etiology in developing countries. However, data for industrialized countries are sparse.
Retrospective analysis of 17 patients treated with perineal urethroplasty 2001-2010. Data were assessed by chart review and non-validated standardized questionnaire. Hypospadias cases were excluded. Reconstruction was performed by stricture excision and primary anastomosis, or a single-staged or two-staged buccal mucosa graft.
Mean age at surgery was 7.9 years (range 1-13) and mean follow-up was 42.6 months (4-115). Eight patients (47.1%) had post-traumatic strictures, five (29.4%) had a history of posterior valves, and previous transurethral catheterization and irradiation each accounted for one patient (5.9%). In the remaining two (11.8%), the etiology was unknown. The success rate was 88.9%. All but one patient were continent postoperatively.
Most common etiology for open urethral reconstruction in children was trauma and previous valve treatment. In our hands the perineal approach for stricture repair is safe and successful. Stricture recurrence rate is low, and incontinence is only associated with additional bladder neck trauma.
评估工业化国家儿童后尿道和/或球部狭窄的病因，并评估经会阴入路修复的结果。儿童尿道狭窄罕见，且常难以治疗。创伤是发展中国家的主要病因。然而，工业化国家的数据较少。
回顾性分析了 2001 年至 2010 年间接受会阴尿道成形术治疗的 17 例患者。通过病历回顾和非验证的标准化问卷评估数据。排除了尿道下裂病例。重建采用狭窄切除和一期吻合，或单期或两期颊黏膜移植。
手术时的平均年龄为 7.9 岁（范围 1-13 岁），平均随访时间为 42.6 个月（4-115 个月）。8 例（47.1%）为创伤后狭窄，5 例（29.4%）有后尿道瓣膜病史，以前经尿道导尿和放疗各占 1 例（5.9%）。在其余 2 例（11.8%）中，病因不明。成功率为 88.9%。除 1 例外，所有患者术后均能控制排尿。
儿童开放性尿道重建最常见的病因是创伤和先前的瓣膜治疗。在我们手中，会阴入路治疗狭窄是安全且成功的。狭窄复发率低，仅与膀胱颈部额外创伤有关。
