Swallow Matthew S, Sharadin Cynthia A, Schaeffer Anthony J, Jacobson Deborah L, Lau Glen A
Division of Urology, Department of Surgery, University of Utah/Primary Children's Hospital, Salt Lake City, UT, United States.
Front Pediatr. 2024 Sep 25;12:1434021. doi: 10.3389/fped.2024.1434021. eCollection 2024.
To investigate the clinical presentation and outcomes for a series of female pediatric patients with severe anterior deflection of the urinary stream (ADUS) who were managed via urethromeatoplasty.
This single institution retrospective cohort study used the institutional billing database to identify female patients ≤18 years who received a urethromeatoplasty (CPT 53450) from 2007 to 2022. Patients were included if a substantial anterior deflection of their urinary stream was the primary indication for surgery. Patients were excluded if they were >18 years of age, had a history of prior genital trauma, or underwent surgery for an indication other than a deflected urinary stream.
Twenty female patients underwent urethromeatoplasty between 2007 and 2022, with a median age of 3 years old. All patients presented with difficulty aiming the urinary stream during toilet training and demonstrated a web of tissue along the posterior aspect of the urethral orifice. 19/20 patients noted immediate response (i.e., normal, non-deflected urinary stream) after the urethromeatoplasty with no further urinary complaints. There were no post-operative complications within a 90-day period.
ADUS is a clinical entity characterized by a web of deflecting tissue at the female posterior urethral meatus that causes severe urinary deflection without other urologic symptoms. This is not well-described in the literature. Surgical correction via urethromeatoplasty is safe and effective.
探讨一系列经尿道外口成形术治疗的女性小儿严重尿流前偏（ADUS）患者的临床表现及治疗结果。
这项单机构回顾性队列研究利用机构计费数据库，确定2007年至2022年间接受尿道外口成形术（CPT 53450）的18岁及以下女性患者。如果尿流明显前偏是手术的主要指征，则纳入患者。如果患者年龄大于18岁、有既往生殖器创伤史或因尿流偏斜以外的指征接受手术，则排除患者。
2007年至2022年间，20名女性患者接受了尿道外口成形术，中位年龄为3岁。所有患者在如厕训练期间均表现出尿流瞄准困难，并在尿道口后方可见一片组织。20例患者中有19例在尿道外口成形术后即刻出现反应（即尿流正常、无偏斜），且无进一步的泌尿系统主诉。90天内无术后并发症。
ADUS是一种临床实体，其特征是女性后尿道外口处有一片偏转组织，导致严重的尿流偏斜且无其他泌尿系统症状。这在文献中描述较少。经尿道外口成形术进行手术矫正安全有效。
