Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

11:35 - 11:38

S15-4

(PP)

VOIDING OUTCOME OF POSTERIOR URETHROPLASTY IN BOYS

Sajid SULTAN, Sadaf ABA UMER KODWAVWALA and Bashir AHMED

Sindh Institute of Urology & Transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN

PURPOSE

To evaluate the voiding outcome of Bulboprostatic Urethroplasty in boys with traumatic stricture urethra.

MATERIAL AND METHODS

Retrospective records of 59 boys who had post traumatic posterior urethral strictures with pelvic fracture and distraction

injuries underwent delayed single stage Bulboprostatic End to End Anastomotic Urethroplasty between 2005 to

2014.Urethroplasty was performed through perineal or abdominoperineal approach.Postoperatively urethral catheter

was removed at 3–4 weeks and VCUG was performed.Voiding outcome was assessed by postoperative VCUG,able to

achieve per urethral voiding, uroflowmetry,any element of urge and/or stress incontinence,dribbling of urine and need to

wear diapers/pads.

RESULTS

Fifty nine boys,mean age 10.73±2.3 years.Off them 31(52%) had RTA, 16 (27%)had history of fall and 12 (20%)had

crush injury.All patients had supra pubic cystostomy Eighteen boys had failed urethroplasty,seven railroad

catheterization before presenting to us.Preoperative cystoscopy and cystogram revealed normal bladder neck in

30(51%)others had open and or fixed bladder neck,normal veru and posterior urethra was seen in 49 (83%).Approach

was perineal in 43(73%) and abdominoperineal in 16(27%).All 59 (100%)boys had catheter removal,VCUG and per

urethral voiding at 3 to4 weeks

them 43 (73%)achieved normal per urethral voiding with day and

night continence and a mean Q-max 13.1 mls/sec.Other 13 (22%)patients had some element of incontinence with mean

Q-max of 12.0 mls/sec.Two has some urge incontinence and two has stress incontinence. Four patients dribbles

occasionally.None of the patient required diapers or pads.Three patients (5%) were wet all the time and were subjected

to bladder neck deflux, 2 became continent day and night and one for day time only.

CONCLUSIONS

Majority of our patients were able to achieve per urethral voiding with adequate flow rates and day and night

continence. Majority of these patients were managed through perineal approach only. Fixed and open bladder neck may

be contributory factors to some element of residual incontinence.