Predictors for recurrence after urethroplasty in pediatric and adolescent stricture urethra.

Autor: Vashishtha S; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India., Sureka SK; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India., Kumar J; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India., Prabhakaran S; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India., Kapoor R; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India., Ansari MS; Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India. Electronic address: ansarimsa@hotmail.com.
Jazyk: angličtina
Zdroj: Journal of pediatric urology [J Pediatr Urol] 2014 Apr; Vol. 10 (2), pp. 268-73. Date of Electronic Publication: 2013 Sep 25.
DOI: 10.1016/j.jpurol.2013.08.014
Abstrakt: Objective: This study aims at evaluating factors predicting recurrence of urethral stricture following urethroplasty in pediatric patients at a tertiary care center.
Patients and Methods: Fifty-two patients of up to 18 years of age, who underwent urethroplasty, were reviewed. Duration of symptoms, etiology, previous intervention, and site of stricture, surgical modality, stricture length, and spongiofibrosis at stricture site, recurrence, and ancillary procedures required were recorded.
Results: Forty-two (82.76%) patients (Group I) had recurrence-free course on follow-up. Of the 10 patients with recurrence (Group II), 9 had PTS and 1 had IS (p = 0.04). Most of the factors evaluated did not differ statistically between the groups; however, length of stricture (1.8 vs. 4.3 cm, p < 0.001) and degree of spongiofibrosis (61% vs. 90%, p = 0.003) were significantly different. Seven patients with recurrence were managed with single procedures, but three required multiple procedures because of multiple recurrences. History of incision and drainage for paraurethral abscess was significantly higher (28.6% vs. 100%, p = 0.002) in patients who had multiple recurrences.
Conclusions: Etiology, fibrosis at local site, and stricture length have significant impact on recurrence of pediatric urethral stricture disease. Associated paraurethral abscess may further compromise the outcome of urethroplasty.
(Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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