title: An evaluation of the effectiveness of external urethral meatus incision in girls with an anterior deflected urinary stream and symptoms of detrusor overactivity.
abstract: BACKGROUND
  Urethral stenosis or abnormalities in the external urethral meatus in girls may lead to serious functional bladder outlet obstruction and recurrent urinary tract infections.
  
  
  OBJECTIVE
  The aim of the study was to analyze the efficacy of meatotomy in girls with an anterior deflected urinary stream (ADUS) and symptoms of detrusor overactivity.
  
  
  METHODS
  A group of 67 girls between the ages of 5 and 16 (mean age: 8.6 years) with symptoms of detrusor overactivity participated in the study. The girls were treated with oxybutinin in the years 2010-2011. The group included 37 girls with ADUS (the ADUS group) while the remaining 30 girls (the OXY group) were found to have a normal urinary stream. In the ADUS group an external urethral meatus incision was performed. The follow-up period was three months. The presence of urinary tract infections (UTI) as well as nocturnal bedwetting and daytime incontinence were analyzed before and after treatment.
  
  
  RESULTS
  After three months, in the ADUS group no UTI was found in 12 children (32%) (p < 0.05), including 11 patients with prior febrile UTI (p < 0.05). Recovery from daytime urinary incontinence was observed in 20 girls (54%) and recovery from nocturnal bedwetting in 8 girls (22%). In the OXY group no infections were found in three girls (10%); recovery from daytime urinary incontinence was noted in 21 girls (70%) and from nocturnal bedwetting in 10 girls (33%).
  
  
  CONCLUSIONS
  Girls with symptoms of detrusor overactivity accompanied by an anterior deflected urinary stream experience UTIs and fever more often than girls with detrusor overactivity and a normal urinary stream. An incision in the external urethral meatus in girls with ADUS and detrusor overactivity seems to be effective treatment for recurrent urinary tract infections, especially febrile ones.
authors.affiliation: Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Apoznański
authors.affiliation: Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Polok
authors.affiliation: Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Rysiakiewicz
authors.affiliation: Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Rysiakiewicz
authors.affiliation: Department of Pathomorphology, Wroclaw Medical University, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kolęda
authors.affiliation: Department of Urology and Oncology, Wroclaw Medical University, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Tupikowski
authors.affiliation: Department of Palliative Care Nursing, Wroclaw Medical University, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szydełko
authors.affiliation: Department and Clinic of Pediatric Nephrology, Wroclaw Medical University, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kiliś-Pstrusińska
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery*; D053201:Urinary Bladder, Overactive / Q000601:surgery*; D014555:Urination Disorders / Q000601:surgery*