Post-traumatic posterior urethral stricture in children: How to achieve a successful repair

Pelvic fracture urethral distraction defects in children managed by anterior sagittal trans anorectal approach: A facilitating and safe acess

“…Pelvic fractures in children tend to be unstable, and if compared to those in adults, they are more likely to be associated with a posterior urethral injury [4]. Given the fragility of the membranous urethra and of the puboprostatic ligaments, associated with a still underdeveloped prostate, such posterior urethral injuries tend to be complete disruptions, with a more intense upper dislocation of the prostate [4]. Also more frequently the prostatic urethra and the bladder neck may be involved in the injury [4].…”

“…Given the fragility of the membranous urethra and of the puboprostatic ligaments, associated with a still underdeveloped prostate, such posterior urethral injuries tend to be complete disruptions, with a more intense upper dislocation of the prostate [4]. Also more frequently the prostatic urethra and the bladder neck may be involved in the injury [4]. Thus, it is not only the fact that a child's hips are smaller that renders urethroplasty difficult.…”

“…In most such patients, the posterior urethra approach for urethroplasty is through the perineal access [1e3], In children, due to anatomic peculiarities, urethroplasties are not as successful. Posterior urethra trauma injuries tend to be complete ruptures, with a more intense upper dislocation of the prostate [4], characteristics that increase their treatment complexity. It is also consensus that the need to resort to the transpubic perineal-abdominal access to perform the urethroplasty is more frequent in children [5].…”

Traumatic strictures of the posterior urethra in boys with special reference to recurrent strictures

“…Many substitution techniques have been described e skin grafts, scrotal inlay procedures, mucosal grafts and free flaps, but their results are poor [3,22,23]. We have earlier described the use of pedicled appendix in 2 cases [5].…”

Acquired posterior urethral diverticulum following surgery for anorectal malformations

“…The most common urologic complications occurring with the surgical management of ARMs are rectourinary fistulas (23.3%), bladder injuries (22.5%), urethral injuries (20.2%), posterior urethral diverticula (17.8%), injuries to the external genitalia (14%), and ureteral injuries (0.8%) [1]. Urethral diverticulum in males without ARM may be congenital in origin [3][4][5] or may occur following trauma, urethral stricture, or prior urethroplasty [5,6].…”