Uroflowmetry Before and After Meatotomy in Boys with Symptomatic Meatal Stenosis Following Neonatal Circumcision - A Long-term Prospective Study.

Autor: Neheman A; Urology Department, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler School of Medicine, Tel Aviv University, Israel., Rappaport YH; Urology Department, Assaf Harofeh Medical Center, Zerifin, affiliated to Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: yhrapp@gmail.com., Darawsha AE; Urology Department, Meir Medical Center, Kfar Saba, affiliated to Sackler School of Medicine, Tel Aviv University, Israel., Leibovitch I; Urology Department, Meir Medical Center, Kfar Saba, affiliated to Sackler School of Medicine, Tel Aviv University, Israel., Sternberg IA; Urology Department, Meir Medical Center, Kfar Saba, affiliated to Sackler School of Medicine, Tel Aviv University, Israel.
Jazyk: angličtina
Zdroj: Urology [Urology] 2019 Mar; Vol. 125, pp. 191-195. Date of Electronic Publication: 2018 Dec 12.
DOI: 10.1016/j.urology.2018.12.005
Abstrakt: Objective: To assess uroflowmetry in the long-term follow-up of symptomatic meatal stenosis patients prior to and following meatotomy. Severity of symptoms and treatment success has been defined by patient history, physical examination, and witnessed voiding. Uroflowmetry might add objective parameters for the assessment, however long-term data are lacking.
Methods: A prospective study following 25 symptomatic toilet-trained boys before and after meatotomy was performed with short and long-term follow-up after surgery. Patient history, physical examination, and uroflowmetry variables were recorded.
Results: Fifteen patients were fully evaluable. Mean age at operation was 6.4 years (2.5-10.5) with an average follow-up of 43 months. All patients were symptomatic before surgery; complete symptomatic resolution was achieved in all patients at short-term follow-up, and in 12 at long-term follow-up. A stenotic meatus was seen in all patients before surgery, at long-term follow-up 12 of 15 (80%) had an open appearing meatus (P = .0001). Abnormal uroflowmetry pattern was present in 8 of 15 (53%) prior to surgery and 2 of 15 (13%) at long-term follow-up (P = .02). Normal maximal flow rate as defined by ICCS were seen in 5, 11, and 12 patients before, 1 month after and at long-term follow-up (P = .06 and 0.02, respectively). PVR improved significantly at long-term follow-up (P = .0012).
Conclusion: Symptom evaluation and physical examination should be the hallmark assessing children with meatal stenosis. Clinical assessment one month after surgery suffices and long-term follow-up is unnecessary. Uroflowmetry provides objective assessment as well as surgical success; however, it is unnecessary since it does not change the management.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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