SURGICAL-MANAGEMENT OF TRAUMATIC POSTERIOR URETHRAL STRICTURES IN CHILDREN

We review our recent experience with the treatment of traumatic strict ures of the posterior urethra in children. Five males, ages six to sev enteen years with dense posterior urethral strictures, have required o pen reconstructive procedures. Four patients had injury secondary to p elvic fractures, and 1 patient had an iatrogenic injury from surgery f or imperforate anus. Two patients were repaired perineally, 2 with a c ombination retropubic-perineal approach, and 1 patient required a tran spubic approach. Excision and direct anastomosis was achieved in 3 pat ients, and a foreskin interposition tube graft was used in 2 patients. Excellent results were achieved with return of urethral voiding and p reservation of continence in all patients. Complications were seen in 3 patients. One secondary internal urethrotomy was required. Erectile capability was preserved in all patients who were potent before surger y. Posterior urethral strictures in children can be successfully manag ed with a variety of surgical approaches. This experience demonstrates that the surgical procedure must be individualized depending on the a natomy of the injury.