One-stage membranous urethroplasty in childhood.

Seven boys with short membranous urethral strictures were treated with a single stage perineal urethroplasty. Anterior urethral mobilization lengthened the urethra sufficiently for a bulboprostatic anastomosis free of tension and in no case was transpubic surgery required. The result was ultimately satisfactory for all children. Although the perineum is proportionately narrower in children than in adults, the depth of the membranous urethra from the skin level is reduced to an even greater degree. As a result exposure of the membranous urethra in children, particularly young children, often is easier than might be anticipated on the basis of imagined miniaturization of adult dimensions. We recommend an initial perineal approach for all short membranous urethral strictures in children with conversion to the transpubic approach if complications or a longer stricture is encountered.