title: Perineal anastomotic urethroplasty for managing post-traumatic urethral strictures in children: the long-term outcome.
abstract: OBJECTIVE
  To evaluate the long-term results of one-stage perineal anastomotic urethroplasty for post-traumatic paediatric urethral strictures.
  
  
  METHODS
  Thirty-five boys who had a perineal anastomotic urethroplasty for post-traumatic bulbous or posterior urethral strictures between 1991 and 2003 were analysed retrospectively. Patients were followed up for a mean (range) of 46 (6-132) months by a history, urinary flow rate estimate, retrograde urethrography and voiding cysto-urethrography.
  
  
  RESULTS
  The mean (range) age of the patients was 11.9 (6-18) years. The estimated radiographic stricture length before surgery was 2.6 (1-5) cm. The perineal anastomotic repair was successful in 31 of 35 (89%) patients. All treatment failures were at the anastomosis and were within the first year. Failed repairs were successfully managed endoscopically in two patients and by repeat perineal anastomotic repair in the remaining two, giving a final success rate of 100%. All boys are continent except two who had early stress incontinence, and that resolved with time. There was no chordee, penile shortening or urethral diverticula during the follow-up.
  
  
  CONCLUSIONS
  The overall success of a one-stage perineal anastomotic repair of post-traumatic urethral strictures in boys is excellent, with minimal morbidity. Substitution urethroplasty or abdomino-perineal repair should be reserved for the occasional patients with concomitant anterior urethral stricture disease or a complex posterior urethral stricture, respectively.
authors.affiliation: The Urology & Nephrology Centre, Mansoura University, Mansoura, Egypt. athafez@yahoo.com
authors.forename: Ashraf T
authors.initials: AT
authors.lastname: Hafez
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Assmy
authors.forename: Osama
authors.initials: O
authors.lastname: Sarhan
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: El-Hefnawy
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Ghoneim
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D006801:Humans; D008297:Male; D010410:Penile Erection / Q000502:physiology; D011859:Radiography; D012189:Retrospective Studies; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014554:Urination / Q000502:physiology