Revision of the External Urinary Meatus in Girls: A Clinical Appraisal

Harvard, B. Marvin

doi:10.1016/s0022-5347(17)61930-x

Cited by 9 publications

(1 citation statement)

References 5 publications

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“…In 1970, Harvard criticized the concept of distal urethral stenosis and described an anomaly of the external urethral meatus in girls with recurrent UTIs, i.e ‘the inferior aspect of the infant meatus is often thick and tough and appears to be a part of the hymenal ring’; this is similar to the ‘meatal web’. The anomaly was even treated in the same way, except that instead of incision, Harvard performed an excision of the meatal web [8]. Most of the patients treated by Harvard had recurrent UTI, but also typical symptoms of dysfunctional voiding, e.g.…”

Section: Discussionmentioning

confidence: 99%

Anomalies of the external urethral meatus in girls with non‐neurogenic bladder sphincter dysfunction

Hoebeke¹,

Laecke²,

Raes

et al. 1999

BJU International

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Objective To investigate in a prospective study the clinical and urodynamic characteristics associated with the correlation previously reported between non‐neuropathic bladder sphincter dysfunction and minimal meatal deformities in girls. Patients and methods From January 1995 to June 1996 all girls referred for urodynamics to investigate non‐neuropathic bladder sphincter dysfunction were examined for meatal anomalies. Two types of meatal anomalies were recognized, i.e. hypospadias, in which the urethral meatus is displaced dorsally and meatal web or covered hypospadias, in which there is a mucosal web on the dorsal side of the urethral meatus that deflects the urinary stream anteriorly. The girls presenting with minimal meatal deformities were compared with those presenting a normal meatal configuration for their history and video‐urodynamic features. Results During the study, 288 girls were referred for video‐urodynamics; 88 presented with meatal anomalies (24 hypospadias and 64 covered hypospadias) and comprised the study group; all other girls were considered as the control group. Incontinence during the day was more frequent in the study group (56%) than in the control group (34%) (P=0.003). Nocturnal enuresis was more frequent in the control group (87%) than in the study group (68%, P=0.006). Urge was more frequent in the study group (80%) than in the control group (65%, P=0.02), as was anterior deflection of the urinary stream (voiding over the toilet rim), in 48% and 4.5%, respectively (P<0.001). On video‐urodynamics, dysfunctional voiding (detrusor sphincter dyscoordination during voiding) was more frequent in the study group (59%) than in the control group (38%, P=0.009), and vaginal voiding was more frequent in the study group (40%) than in the control group (11.5%, P<0.001). Conclusion Girls presenting with meatal anomalies have more severe dysfunction, as estimated by urodynamics. Although the natural history of these anomalies and the incidence in the normal population is not known, it is thought that there is an aetiological correlation between the functional voiding disorders and the meatal anomaly. Surgical treatment to correct the anomalies is proposed.

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Section: Discussionmentioning

confidence: 99%

Anomalies of the external urethral meatus in girls with non‐neurogenic bladder sphincter dysfunction

Hoebeke¹,

Laecke²,

Raes

et al. 1999

BJU International

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The wide bladder neck and posterior urethra in childhood

Lang

Töth

Gombos

et al. 1985

International Urology and Nephrology

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Involvement of anomalies of the bladder and urethra in recurrent urinary tract infections and micturition disorders in children are examined in the light of published evidence and of the authors' own observations. The data of 300 children followed up for a wide bladder neck and posterior urethra at the Nephrology Clinic of Heim Pál Children's Hospital, Budapest, are reviewed. The dilatation in question is regarded as functional, attributable to a congenital neurogenic or myogenic defect. For the management and prevention of the recurrent ascending infections long-term urinary disinfection and meticulous toilet of the external meatus are recommended. The symptoms are expected to subside spontaneously at the age of menarche. The importance of a close nephrologic follow-up is emphasized.

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