Ballouhey Q, Galinier P, Gryn A, Grimaudo A, Pienkowski C, Fourcade L
Service de chirurgie viscérale pédiatrique, Hôpital des Enfants, 8 avenue Dominique Larrey, 87042 Limoges Cedex, France.
Service de chirurgie viscérale pédiatrique, Hôpital des Enfants, 330 avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France.
J Pediatr Urol. 2014 Feb;10(1):94-7. doi: 10.1016/j.jpurol.2013.06.011. Epub 2013 Jul 31.
Urethral prolapse (UP) is a complete eversion of the distal urethral mucosa through the external meatus. UP must be distinguished by examination from trauma, prolapsed ureterocele, tumors or sexual abuse. Its management remains controversial. The aim of the study was to promote the benefits of primary surgical management for UP.
A retrospective multicenter review of children who received surgery for UP between 1991 and 2011 was carried out. Non-complicated UP was primarily treated conservatively. A total of 19 patients were referred for complicated UP and underwent resection of the prolapsed urethral mucosa.
The mean delay in diagnosis was 2.2 days (range 1-6) and the most common symptoms were vaginal spotting and bleeding. No predisposing factor was found, but most patients had a mean weight, height and BMI greater than the 50th percentile. All patients underwent surgery successfully. One patient experienced a complication, i.e., dysuria. There was no case of recurrence after a mean 28 months of follow-up.
Early detection is based on bedside examination. The first-line treatment strategy for uncomplicated UP should be conservative management. Surgical resection is safe and effective for patients with significant symptoms.
尿道脱垂是尿道远端黏膜经尿道口完全外翻。尿道脱垂必须通过检查与创伤、输尿管囊肿脱垂、肿瘤或性虐待相鉴别。其治疗仍存在争议。本研究的目的是推广尿道脱垂一期手术治疗的益处。
对1991年至2011年间接受尿道脱垂手术的儿童进行回顾性多中心研究。非复杂性尿道脱垂主要采用保守治疗。共有19例复杂性尿道脱垂患者转诊并接受了脱垂尿道黏膜切除术。
诊断的平均延迟时间为2.2天（范围1 - 6天），最常见的症状是阴道点滴出血和出血。未发现诱发因素，但大多数患者的平均体重、身高和体重指数高于第50百分位数。所有患者均成功接受手术。1例患者出现并发症，即排尿困难。平均随访28个月后无复发病例。
早期诊断基于床旁检查。非复杂性尿道脱垂的一线治疗策略应为保守治疗。手术切除对有明显症状的患者安全有效。
