Lammers Rianne J M, Enache Tudor, Faraj Sebastien, Waterschoot Mieke, Tiryaki Sibel
Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.
Department of Pediatric Surgery, Hôpital Femme-Mère-Enfant, Lyon, France.
Eur Urol Open Sci. 2025 Oct 13;82:41-51. doi: 10.1016/j.euros.2025.09.016. eCollection 2025 Dec.
Pediatric urethral trauma is rare, and treatment recommendations are often extrapolated from evidence for adults. We conducted a systematic review of the literature to evaluate management strategies, outcomes, and the quality of reporting for pediatric urethral trauma.
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 31 relevant studies published since 1990. Studies were eligible for inclusions if they reported results for five or more patients with at least 3 mo of follow-up for noniatrogenic urethral trauma. Methodological quality was assessed using the Methodological Index for Nonrandomized Studies (MINORS) tool.
The quality of evidence was low: most studies were retrospective single-center cohorts and there was inconsistent reporting of management and outcomes. Open reconstruction was reported more frequently than endoscopic management. Across treatment modalities, the overall stricture rate was ∼20%. Continence and sexual function outcomes were generally favorable. However, data on repeat surgery and quality of life were insufficient for firm conclusions.
The most striking finding from our review is the poor quality and inconsistency of the literature on pediatric urethral trauma. As well as summarizing the outcome data available, we provide a table of recommendations for improving future studies, including the use of standardized definitions, validated pediatric patient-reported outcome measures, and consistent long-term follow-up.
We looked at the evidence on treatments and outcomes after accidental damage to the urethra in children. No definitive conclusions can be drawn because the quality of the research is low and inconsistent. We provide advice for future research.
小儿尿道创伤较为罕见，治疗建议常从成人证据推断而来。我们对文献进行了系统回顾，以评估小儿尿道创伤的管理策略、治疗结果及报告质量。
我们遵循系统评价与Meta分析的首选报告项目（PRISMA）指南，确定了自1990年以来发表的31项相关研究。如果研究报告了至少5例非医源性尿道创伤患者且随访至少3个月的结果，则符合纳入标准。使用非随机研究方法学指数（MINORS）工具评估方法学质量。
证据质量较低：大多数研究为回顾性单中心队列研究，管理和结果的报告不一致。开放重建术的报告频率高于内镜治疗。在各种治疗方式中，总体狭窄率约为20%。控尿和性功能结果总体良好。然而，关于再次手术和生活质量的数据不足以得出确切结论。
我们的综述中最显著的发现是小儿尿道创伤文献质量差且不一致。除了总结现有的结果数据外，我们还提供了一份改进未来研究的建议表，包括使用标准化定义、经过验证的小儿患者报告结局测量方法以及一致的长期随访。
我们研究了儿童尿道意外损伤后治疗及结果的证据。由于研究质量低且不一致，无法得出明确结论。我们为未来研究提供了建议。
