title: Role of visual internal urethrotomy in pediatric urethral strictures.
abstract: OBJECTIVE
  To evaluate the efficiency of visual internal urethrotomies (VIUs) in pediatric patients.
  
  
  METHODS
  Thirty-four patients aged 0.2-16.3 years were treated with VIUs as a primary treatment for urethral stricture at our institution during 1980-2010. The stricture characteristics and need for repeat treatments as well as the results of repeat VIUs or dilatations were evaluated in a long-term follow-up.
  
  
  RESULTS
  Each time first VIUs or repeat treatments were carried out there was a 22-33% success rate at 5 years. Twenty-four patients (71%) were treated successfully after repeat VIUs or dilatations at a median of 6.6 years' follow-up. None of the five patients with strictures longer than 2 cm were successfully treated, compared with 24 of 29 patients with shorter strictures (p = 0.001). However, stricture etiology or location did not have an impact on success. Currently four patients have undergone an open operation because of stricture and six patients are on a home dilatation program.
  
  
  CONCLUSIONS
  Single VIU is successful for about one-quarter of pediatric patients with a urethral stricture. With repeated VIUs or dilatations 71% of the patients can achieve success. In strictures less than 2 cm, up to three VIUs can be attempted, but longer strictures need open correction if the patient does not wish to follow the home dilatation program.
authors.affiliation: Department of Urology, University of Helsinki, Helsinki, Finland.
authors.forename: Ene
authors.initials: E
authors.lastname: Launonen
authors.affiliation: Department of Urology, University of Helsinki, Helsinki, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Sairanen
authors.affiliation: Department of Urology, University of Helsinki, Helsinki, Finland.
authors.forename: Mirja
authors.initials: M
authors.lastname: Ruutu
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland. Electronic address: seppo.taskinen@hus.fi.
authors.forename: Seppo
authors.initials: S
authors.lastname: Taskinen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Stricture; Urethra; Urethrotomy