1. A new alternative for management of urethral transection in young girl.
- Author
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Jouini, R., Kerkeni, Y., Zouaoui, A., Habbachi, G., Sahli, S., and Thamri, F.
- Subjects
CYSTOSTOMY ,BLADDER obstruction ,URETHRA ,BLADDER - Abstract
Pediatric female urethral injury is rare and the management remains non consensual. Patients presenting at a later stage with obliterate strictures have limited surgical options for repair. The aim was to report an original endosurgical procedure to recreate the urethra after a complete urethral rupture A 6-year-old girl was operated for a ruptured bladder. The attempt to catheterize the urethra failed. We decided to put a suprapubic cystostomy. Cystourethrography, performed 3 weeks postoperatively, showed a complete urethral rupture. The patient was lost to follow-up for 2 years. When returned, the decision was to perform urethra realignment endoscopically with a suprapubic and transurethral approaches. When brought in by the cystostomy, the endoscope showed a normal bladder wall and a stricture of the bladder neck. When introduced by the remaining urethra, it showed a dead-end 1- cm urethra. The intervention consisted on drilling the way from the meatus, to reach the bladder, while controlling the procedure by suprapubic cystoscopy. The result was a urethral path of 1.5cm permitting a normal voiding behavior after the closure of the suprapubic opening. Post traumatic urethral injury in girls is difficult to deal with. Surgical ingenuity and more preservative techniques are necessary and go along with maintaining an acceptable urinary function. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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