Noe H N
Urol Clin North Am. 1983 Aug;10(3):531-6.
In many ways, the management of urethral stricture disease in children parallels that in adults, but striking differences exist. The technical demands made because of the small size of the strictures and the delicacy of the tissues involved certainly provide more of a challenge. Newer instrumentation, improved techniques, and increased experience in children are helping us to meet these challenges. Visual urethrotomy should be considered the initial treatment of choice for anterior urethral strictures, and urethroplasty should be reserved for treatment failures. Attention to technical detail and proper patient preparation will ensure optimum results from urethroplasty. Posterior urethral strictures as a result of pelvic injury can be influenced by proper initial management but remain an open surgical disease of considerable challenge. The fact that in children a large proportion of urethral stricture disease is iatrogenic provides us with a real opportunity for prevention. As with any disease state, prevention or minimization of complications of treatment is the ultimate goal. It is only through a careful, thoughtful approach that we can begin to achieve that end.
在许多方面，儿童尿道狭窄疾病的管理与成人相似，但也存在显著差异。由于狭窄部位较小以及所涉及组织的 delicate 程度，所提出的技术要求无疑带来了更大的挑战。更新的器械、改进的技术以及在儿童治疗方面经验的增加，正在帮助我们应对这些挑战。直视下尿道切开术应被视为前尿道狭窄的首选初始治疗方法，而尿道成形术应留用于治疗失败的情况。注重技术细节和对患者进行适当的准备将确保尿道成形术取得最佳效果。盆腔损伤导致的后尿道狭窄可受到适当的初始处理的影响，但仍然是一种具有相当挑战性的开放性手术疾病。儿童中很大一部分尿道狭窄疾病是医源性的这一事实为我们提供了真正的预防机会。与任何疾病状态一样，预防或尽量减少治疗并发症是最终目标。只有通过谨慎、周全的方法，我们才能开始实现这一目标。
