Idiopathic hemorrhagic urethritis of childhood.

INTRODUCTION

idiopathic hemorrhagic urethritis of childhood (IHU) is uncommon. Data about the disease are limited. There are no available protocols for diagnosis, treatment, or follow-up and prognostic factors are unknown.

OBJECTIVE

We aim to review the available data about IHU, to organize and to synthesize information, to facilitate clinical choices and the establishment of future research protocols.

STUDY

DESIGN

Descriptive review of the literature.

RESULTS

The disease typically affects peri-pubertal boys. A third evolve to chronic disease and circa 15% develop urethral stenoses. Voiding dysfunction is frequent. Acute scrotum secondary to orchiepididymitis may occur. Meatal stenosis and hypospadias are more frequent than in the general population. Diagnosis is clinical (urethrorrhagia ± dysuria). Complementary exams are mostly used for differential diagnosis. Indications for cystoscopy are controversial. Bulbar urethral inflammation with fibrinous "membranes" are typical. Treatment is controversial and mostly expectant. Topical steroids and indwelling catheterization are the most successful for severe or recalcitrant cases (summary table).

CONCLUSION

IHU turns into a chronic condition in a significant proportion of the cases and associates to a low quality of life. Urethral stenosis is the most common complication. Indications for diagnostic cystoscopy, prolonged catheterization, and steroid prescription need to be better defined. Clinical protocols are deeply needed.