Idiopathic urethral stricture in adolescents: A case series presentation and review of the literature
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v83i2.999Keywords:
Idiopathic urethral stricture, Adolescent, Endoscopic urethrotomyAbstract
Objective: To present our case series of idiopathic urethral stricture in adolescents, analyzing the treatments applied and the results obtained.
Methods: A retrospective study of 7 patients with idiopathic urethral stricture treated at our center between 2000 and 2021 was performed.
Results: The average age at the moment of surgery was 14.7 years. In 85% of cases the main symptom was voiding difficulty. The diagnosis was by voiding cystourethrography (VCUG) in five patients and by cystoscopy in two, locating the stricture in the anterior urethra in all cases. Six patients were treated with endoscopic urethrotomy and one with balloon dilation. Two patients recurred. The subsequent treatment in both cases was a second endoscopic urethrotomy and one of them required a posterior urethroplasty. Currently 6 out of 7 patients are asymptomatic and the patient who underwent urethroplasty is undergoing regular dilations.
Limitations: The number of patients is limited due to the shortage of this pathology in childhood.
Value: The available literature is quite limited. It is usually secondary to trauma or surgical interventions such as hypospadias repair. Idiopathic etiology represents less than a third of urethral strictures in adolescents and it causes the greatest controversy regarding its management.
Conclusions: We should suspect idiopathic urethral stricture in childhood when symptoms appear, such as voiding difficulty in patients without previous pathologies. VCUG can help diagnosis, but a cystoscopy allows diagnosis and treatment at the same time. Endoscopic urethrotomy should be the treatment of choice for idiopathic strictures smaller than 1 cm, since the success rate is greater than 85%.
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