Abstract

Objective: Posterior urethral trauma is rare type of trauma that is particularly difficult to treat in children. Here, we havepresented our experience with tubularised buccal mucosal graft (BMG) repairs for posterior pelvic fracture urethraldistraction defects (PFUDDs) in children.

Material and Methods: We retrospectively evaluated three cases of tubularised BMG repairs for PFUDDs in ourclinic between 2009 and 2016. The BMGs were 3 cm in length, on average, and sutured between the stump of theproximal prostatic urethra and the distal bulbar urethra. All of the patients underwent urethrography, urethroscopy anduroflowmetry assessments postoperatively.

Results: The mean patient age was 9 (6–14) years and all three patients were male. Two of the three patients withposterior urethral injuries were operated on at least twice at another centre and referred to our clinic with PFUDDs. Allthree patients underwent tubularised BMG urethroplasties for the PFUDDs. We noted urethral integrity in the cystoscopicevaluations of two of the patients, with no strictures, and these two patients were fully continent. A proximal anastomoticcontracture was noted in the third patient and a revision was required.

Conclusion: A tubularised BMG should be used to prevent penile shortening and anastomotic tension in a PFUDD.

Keywords: Trauma, Urethra

References

  1. 1. Bariol SV, Stewart GD, Smith RD, Mc Keown DW, Tolley DA. An
  2. analysis of urinary tract trauma in Scotland: Impact on management
  3. and resource needs. Surgeon 2005;3:27-30.
  4. 2. Kashefi C, Messer K, Barden R, Sexton C, Parsons JK. Incidence
  5. and prevention of iatrogenic urethral injuries. J Urol 2008;179:2254-
  6. 7.
  7. 3. Trachta J, Moravek J, Kriz J, Padr R, Skaba R. Pediatric bulbar
  8. and posterior urethral injuries: Operative outcomes and long-term
  9. follow-up. Eur J Pediatr Surg 2016;26:86-90.
  10. 4. Singla M, Jha K, Muruganandam S, Srivastava A, Ansari MS,
  11. Mandhani A, et al. Posttraumatic posterior urethral strictures in
  12. children-management and intermediate-term follow-up in tertiary
  13. care centre. Urology 2008;72:540-4.
  14. 5. Koraitim MM. Posttraumatic posterior urethral strictures in children:
  15. A 20-year experience. J Urol 1997;157:641-5.
  16. 6. Voelzke BB, Breyer BN, McAninch JW. Blunt paediatric anterior
  17. and posterior urethral trauma: 32-year experience and outcomes.
  18. J Pediatr Urol 2012;8:258-63.
  19. 7. Aggarwal SK, Sinha SK, Kumar A, Pant N, Borkar NK, Dhua A.
  20. Traumatic strictures of the posterior urethra in boys with special
  21. reference to recurrent strictures. J Pediatr Urol 2011;7:356-62.
  22. 8. Xu YM, Qiao Y, Sa YL, Wu DL, Zhang XR, Zhang J, et al. Substitution
  23. urethroplasty of complex and long-segment urethral strictures:
  24. A rationale for procedure selection. Eur Urol 2007;51:1093-8.
  25. 9. Pansadoro V, Emiliozzi P. Which urethroplasty for which results?
  26. Curr Opin Urol 2002;12:223-7.
  27. 10. Pansadoro V, Emiliozzi P, Gaffi M, Scarpone P, DePaula F, Pizzo
  28. M. Buccal mucosa urethroplasty in the treatment of bulbar urethral
  29. stricture. Urology 2003;61:1008-10.

How to cite

1.
Güney D. Tubularised Buccal Mucosal Graft Urethroplasty for Posterior Pelvic Fracture Urethral Distraction Defects in Children. Turk J Pediatr Dis [Internet]. 2019 May 24 [cited 2025 May 24];13(3):126-9. Available from: https://turkjpediatrdis.org/article/view/601