David T Chiang1, Paddy A Dewan. 1. Department of Pediatric Urology, Sunshine Hospital, Western Health, Melbourne, Australia. davidtwchiang@yahoo.com.au
Abstract
INTRODUCTION: A simple technique to dilate urethral stricture using guide wire and sheath dilator has been described in pediatric urology. The aim of this study was to report the long-term outcome of the children who underwent dilation of the urethral stricture using guide wire and sheath dilator. MATERIALS AND METHODS: From 1999 to 2004, a total of 52 children with documented urethral stricture were managed by urethral dilation using guide wire. Data on the cause of urethral stricture, operation, postoperative recovery, follow-up cystoscopic appearance, and patient's outcome were audited and analyzed. RESULTS: The mean age of the patients was 5.6 +/- 2.3 years (range, 2 to 18 years). The mean period of the follow-up was 4.5 +/- 2.4 years (range, 3.8 to 6.5 years). Twenty-two patients (42.3%) did not require any further surgical treatments. However, urethral stricture in 13 patients (25.0%) progressed significantly, and therefore, they needed further surgical interventions. The complications included minor urinary tract infections in 3 and bladder spasm in 2 patients. No case of false passage or sepsis was encountered. CONCLUSION: Guide wire-assisted urethral dilation avoids the risks associated with blind dilation techniques and continues to be a safe alternative for urethral strictures in selected cases. However, in our experience, less than half of the patients became "recurrence free" after two dilation attempts. We recommend that urethral dilation be considered only in selected cases and emergency settings.
INTRODUCTION: A simple technique to dilate urethral stricture using guide wire and sheath dilator has been described in pediatric urology. The aim of this study was to report the long-term outcome of the children who underwent dilation of the urethral stricture using guide wire and sheath dilator. MATERIALS AND METHODS: From 1999 to 2004, a total of 52 children with documented urethral stricture were managed by urethral dilation using guide wire. Data on the cause of urethral stricture, operation, postoperative recovery, follow-up cystoscopic appearance, and patient's outcome were audited and analyzed. RESULTS: The mean age of the patients was 5.6 +/- 2.3 years (range, 2 to 18 years). The mean period of the follow-up was 4.5 +/- 2.4 years (range, 3.8 to 6.5 years). Twenty-two patients (42.3%) did not require any further surgical treatments. However, urethral stricture in 13 patients (25.0%) progressed significantly, and therefore, they needed further surgical interventions. The complications included minor urinary tract infections in 3 and bladder spasm in 2 patients. No case of false passage or sepsis was encountered. CONCLUSION: Guide wire-assisted urethral dilation avoids the risks associated with blind dilation techniques and continues to be a safe alternative for urethral strictures in selected cases. However, in our experience, less than half of the patients became "recurrence free" after two dilation attempts. We recommend that urethral dilation be considered only in selected cases and emergency settings.