Management of recurrent urethral strictures after hypospadias repair: is there a role for repeat dilation or endoscopic incision?
| Autor: | Amanda W. Cai, Joseph G. Borer, Alan B. Retik, Patricio C. Gargollo |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Urologic Surgical Procedures Male Urethral stricture Urethroplasty medicine.medical_treatment Urology Urologic Surgical Procedure Urethra Recurrence medicine Hypospadias repair Humans Urethral Stricture Hypospadias medicine.diagnostic_test business.industry Infant Endoscopy medicine.disease Dilatation Surgery Treatment Outcome Endoscopic incision Child Preschool Pediatrics Perinatology and Child Health Dilation (morphology) business |
| Zdroj: | Journal of pediatric urology. 7(1) |
| ISSN: | 1873-4898 |
| Popis: | Objective Urethral strictures are among the most common complications after hypospadias repair. We report our 10-year experience with endoscopic incision or dilation of urethral strictures after hypospadias repair, to determine the best management technique. Methods All cases of urethral strictures after hypospadias repair treated with direct vision internal urethrotomy (DVIU), dilation or urethroplasty at our institution from 1997 to 2007 were included. Records were reviewed and clinical parameters analyzed. Data were statistically analyzed to identify risk factors for stricture recurrence after initial or subsequent treatment(s). Results Of 2273 patients, 73 were treated for a postoperative urethral stricture and 15 others were referred for stricture treatment. Of these 88 patients, 39 were treated with initial dilation or DVIU and 49 underwent urethroplasty or reoperative hypospadias repair. Fifteen (38%) of the patients treated with initial DVIU or dilation showed no recurrence. Of the patients that did have a recurrence, a repeat DVIU or dilation had a success rate of 17% with no difference in success between these two groups. Choice of therapy between repeat dilation/DVIU and urethroplasty at the second procedure showed a statistically significant higher success rate in the urethroplasty group (67% vs 17%, P = 0.03). Conclusion Although numbers are small, our data suggest that if there is recurrent stricture after initial DVIU/dilation then a formal urethroplasty has a significantly higher success rate than repeat DVIU/dilation. |
| Databáze: | OpenAIRE |
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