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Indian Pediatrics Oct 2022
Topics: Humans; Urethral Diseases; Cysts
PubMed: 36263502
DOI: No ID Found -
TheScientificWorldJournal Oct 2009The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality... (Review)
Review
The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy) are the goals for the care of children with posterior urethral valves[1].
Topics: Fetal Diseases; Humans; Male; Prenatal Diagnosis; Prognosis; Urethra; Urethral Obstruction
PubMed: 19838598
DOI: 10.1100/tsw.2009.127 -
TheScientificWorldJournal Apr 2011Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located... (Review)
Review
Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications.
Topics: Diverticulum; Humans; Hypospadias; Male; Penis; Postoperative Complications; Plastic Surgery Procedures; Urethral Diseases; Urethral Stricture; Urinary Fistula
PubMed: 21516286
DOI: 10.1100/tsw.2011.76 -
BMC Pediatrics Sep 2023Posterior urethral valve (PUV) is the most common congenital bladder outlet obstruction in boys, causing renal damage beginning in utero. There are scarce data from... (Review)
Review
BACKGROUND
Posterior urethral valve (PUV) is the most common congenital bladder outlet obstruction in boys, causing renal damage beginning in utero. There are scarce data from Thailand regarding the long-term outcomes of PUV in boys, thus the aim of this study was to examine the presentation, clinical course, complications, outcomes and renal survival in PUV boys.
METHODS
We reviewed the medical records of PUV boys treated at the Pediatric Nephrology Clinic, Prince of Songkla University, Thailand, over a 30-year-period.
RESULTS
Seventy-seven PUV boys were identified, with a median age at diagnosis of 4.8 months. The most common presentations were urinary tract infection (UTI), poor urine stream and urinary dribbling in 26 (33.8%), 19 (24.7%) and 11 (14.3%) boys, respectively. Renal ultrasound results in 70 boys showed 8 (11.4%) unilateral and 56 (80%) bilateral hydronephroses. Of 72 voiding cystourethrograms, 18 (25.0%) showed unilateral and 22 (30.6%) bilateral vesicoureteral refluxes. Tc dimercaptosuccinic acid renal scans in 30 boys showed 12 (40%) unilateral and 8 (26.7%) bilateral renal damage. Fifty-nine (76.6%) boys had 149 UTIs; 42 (54.4%) had recurrent UTI. Forty-eight boys had valve ablation at the median age of 30.3 months. 22 boys (28.6%) developed chronic kidney disease (CKD) at a median age of 15.0 years.
CONCLUSION
Of 77 PUV Thai boys, UTI was the most common presentation. Recurrence of UTI and CKD was the most common consequence. Lifelong follow-up for renal and bladder functions is essential for all PUV patients.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; Ambulatory Care Facilities; Kidney; Renal Insufficiency, Chronic; Southeast Asian People; Thailand; Urethra; Urinary Bladder Neck Obstruction; Urethral Diseases; Infant, Newborn
PubMed: 37679663
DOI: 10.1186/s12887-023-04281-x -
The Pan African Medical Journal 2017Urethral duplications are extremely rare congenital malformations. The most used classification is that of Effmann and Lebowitz, describing 6 types of urethral...
Urethral duplications are extremely rare congenital malformations. The most used classification is that of Effmann and Lebowitz, describing 6 types of urethral duplications. The under type IIA2-Y is one of the most rare duplications corresponding to duplicated urethra originating from the bladder neck and extending toward the ectopic perineal or anal insertion. We here report the case of a 32 year patient, with no previous personal history, suffering from urinary leakage during and after urination since childhood. Clinical examination showed a bottleneck at the level to the perineum initially suggesting urethral fistula. However, the absence of fistula-associated urinary disorders as well as urinary leakage since childhood refuted this assumption. The patient underwent Micturating Retrograde Urethrocistography after perineal orifice catheterization confirming well systematized tract. Surgical exploration was based on excision of the duplicate urethra after hydrophilic catheterization by inserting hydrophilic guidewire up to its anastomosis at the level of the prostate. The examination of the surgical specimen confirmed the diagnosis of supernumerary urethra.
Topics: Adult; Humans; Male; Urethra; Urethral Diseases; Urinary Fistula; Urologic Surgical Procedures, Male
PubMed: 29187923
DOI: 10.11604/pamj.2017.27.254.12065 -
International Braz J Urol : Official... 2020To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury. (Review)
Review
OBJECTIVE
To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury.
MATERIALS AND METHODS
We searched the Pubmed database between 1998 and 2019 using the following key words: "penile fracture", "fracture of penis", "trauma to penis", "rupture of corpora cavernosa", "urethral injury", "urethral rupture" and "urethral reconstruction".
RESULTS
The incidence of urethral lesion in patients with PF varies by geographic region and etiology. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture. The diagnosis of PF is eminently clinical and complementary exams are not necessary. The treatment consists of urethral reconstruction and the most common complications found are urethral stenosis and urethrocutaneous fistula.
CONCLUSION
PF is an uncommon urological emergency, particularly in cases with urethral involvement. Urethral injury should be suspected in the presence of suggestive clinical signs, and diagnosis is usually clinical. Urgent urethral reconstruction is man-datory and produces satisfactory results with low levels of complications.
Topics: Humans; Male; Penile Diseases; Penis; Rupture; Urethra; Urethral Diseases
PubMed: 31961620
DOI: 10.1590/S1677-5538.IBJU.2020.99.02 -
Journal of the American Veterinary... Dec 2019
Topics: Animals; Male; Polyps; Rupture, Spontaneous; Swine; Swine Diseases; Urethral Diseases; Urinary Bladder
PubMed: 31730437
DOI: 10.2460/javma.255.11.1241 -
BMJ Case Reports Mar 2011A 5-year-old girl of Ghanaian origin presented to the accident and emergency department with genital bleeding of sudden onset in the previous 12 h. A diagnosis of...
A 5-year-old girl of Ghanaian origin presented to the accident and emergency department with genital bleeding of sudden onset in the previous 12 h. A diagnosis of urethral prolapse was made. The congestion and bleeding settled with a daily sitz bath and topical oestrogen cream for 4 weeks, while the prolapse was referred to urologists.
Topics: Child, Preschool; Female; Hemorrhage; Humans; Pelvic Organ Prolapse; Urethral Diseases
PubMed: 22707620
DOI: 10.1136/bcr.04.2010.2955 -
Journal of the American Veterinary... Dec 2020A 3-year-old neutered male domestic shorthair cat with a history of urethral obstruction was evaluated at a veterinary referral center for acute onset of hunched posture...
CASE DESCRIPTION
A 3-year-old neutered male domestic shorthair cat with a history of urethral obstruction was evaluated at a veterinary referral center for acute onset of hunched posture and signs of discomfort on being handled. No evidence of urethral obstruction was found; signs initially responded to medical management, but the cat was presented to the primary care veterinarian < 48 hours after the initial examination with signs suggesting urethral obstruction.
CLINICAL FINDINGS
No urinary calculi were detected radiographically. Attempted urinary catheter placement was unsuccessful, and the cat was returned to the referral center for evaluation and treatment of suspected urethral obstruction. Hematologic evaluation revealed hyperglobulinemia and leukocytosis; the cat was febrile, its prepuce was swollen, and its urinary bladder was soft but could not be manually expressed.
TREATMENT AND OUTCOME
A urinary catheter was placed; urinalysis revealed hematuria, leukocyturia, and bacteriuria. Medical management included analgesic, antimicrobial, urethral antispasmodic, and IV fluid treatment. Positive-contrast cystourethrography results were equivocal for a congenital anomaly versus urethral rupture. Contrast-enhanced CT revealed a sinus communicating with the dorsal aspect of the urethra, and urethral rupture was ruled out. Partial urethral duplication was confirmed surgically; perineal urethrostomy was performed, creating an opening to the accessory urethra, and the strictured orthotopic urethra was ligated. Four weeks after surgery, the cat was doing well.
CLINICAL RELEVANCE
This case highlighted the importance of advanced imaging to distinguish between urethral rupture and a congenital malformation in a cat with signs of lower urinary tract disease. This approach was pivotal to appropriate diagnosis and management and a favorable outcome for the patient.
Topics: Animals; Cat Diseases; Cats; Male; Urethra; Urethral Obstruction; Urethral Stricture; Urinary Bladder; Urinary Catheterization
PubMed: 33269965
DOI: 10.2460/javma.257.12.1273 -
The Pan African Medical Journal 2022
Topics: Diverticulum; Humans; Magnetic Resonance Imaging; Urethral Diseases
PubMed: 35721647
DOI: 10.11604/pamj.2022.41.240.34050