China: A recent study in the journal Urology has preliminary confirmed that progressive anastomotic urethroplasty strategy can ensure a high success rate in preschool boys with pelvic fracture urethral distraction defect (PFUDD). PFUDD in young boys is a uncommon but challenging problem for both the urologist and parent.
In the study, Yinglong Sa, Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, China, and colleagues shared the cases of pelvic fracture urethral distraction defect in preschool boys and evaluated the transperineal anastomotic urethroplasty strategy for the treatment.
For this purpose, the researchers retrospectively reviewed 8 preschool boys (<6 years) with PFUDD underwent the transperineal anastomotic urethroplasty between January 2010 and May 2021. Etiology was traumatic pelvic fracture in all boys.
The type of trauma was fall injury in 1 and vehicle crush injury in 7. Urethroplasty was performed at least 3 months after initial trauma or the last failed intervention. One of them had PFUDD associated with urethrorectal fistula, he received urethroplasty combined with fistula repair. Urethroplasty was considered successful when the patency and continuity of urethra was restored and there was no requirement of further interventions.
Following were the study's key findings:
· Follow-up was obtained in all the 8 preschool boys for 3-135 (median: 65) months. The average age was 4.1 years old.
· After operation, the final success rate was 100%.
Neither stenosis recurrence nor urinary fistulas were reported during follow-up.
· Of the 8 boys, 1 developed urinary incontinence, only occurring after high-intensity exercise such as running.
· Potency state could not be evaluated for all boys due to the young age.
· One boy reported having normal morning erection after a follow-up of 135 months.
"PFUDD in preschool boys is a challenge for both the urologist and parent," wrote the authors. "Our study preliminarily confirmed that the progressive anastomotic urethroplasty strategy can ensure a high success rate."
Reference:
The study titled, "Pelvic Fracture Urethral Distraction Defects in Preschool Boys: How to Recognize and Manage?," was published in the journal Urology.
DOI: https://doi.org/10.1016/j.urology.2021.10.026