title: Transpubic posterior urethroplasty via perineal approach in children: a new technique.
abstract: OBJECTIVE
  To evaluate a new technique of transpubic urethroplasty via perineal approach for management of pelvic fracture urethral distraction defects (PFUDD) in children.
  
  
  METHODS
  Of 78 children undergoing posterior urethroplasty for PFUDD, 12 (15.4%) had a short urethra that could not bridge the gap (>5 cm) for a tension-free anastomosis. Age ranged from 5.2 to 12 years (median = 8.5 years). The median distraction defect length was 4.8 cm (range 3.7-6.4 cm). For the latter group, the new technique of transpubic posterior urethroplasty via perineal approach was performed. The first follow-up visit was scheduled 1 month after suprapubic catheter removal. Radiological studies and uroflowmetry were repeated at 6-month intervals for 1 year and once yearly thereafter.
  
  
  RESULTS
  Patients were followed up for a period of 6 months to 5 years with a mean of 2.7 years. Mean operative time was 2.5 h (range 1.9-3.2 h) with a mean blood loss of 200 ml (range 50-640 cc) and the mean hospital stay was 4 days. All 12 children had a good urinary stream over the follow-up period; 3/12 (25%) developed stress urinary incontinence that resolved within 6 months postoperatively; 9/12 (75%) complained of (retracted) short penis.
  
  
  CONCLUSIONS
  Transpubic urethroplasty via perineal approach is a feasible technique for management of complex PFUDD in children, and presents many advantages over other routes.
authors.affiliation: Urology Department, Alexandria College of Medicine, Alexandria, Egypt. sshorabi004@hotmail.com
authors.forename: Samir
authors.initials: S
authors.lastname: Orabi
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003558:Cystoscopy / Q000379:methods; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D010502:Perineum / Q000601:surgery; D011630:Pubic Bone / Q000601:surgery; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014554:Urination / Q000502:physiology; D014567:Urography / Q000379:methods; D013521:Urologic Surgical Procedures, Male / Q000379:methods*