Urethral stricture disease in children.

We review our experience with urethral stricture disease in 25 children who were seen between 1970 and 1979. Trauma was the most common etiology (48 per cent). Excellent results were obtained by 1-stage repair and multistage skin inlay urethroplasty. An average of 3.8 procedures per patient was required for multistage repairs versus 1.1 procedures per patient for 1-stage repair. Dilation alone averaged 1.7 procedures per patient and was successful in only 20 per cent. Dilation is unacceptable for management of most strictures in children and urethroplasty should be considered early in the treatment plan. One-stage urethroplasty, when applicable, is preferable to multistage repair. Seven children had a fractured pelvis with prostatomembranous urethral disruption, which was complete in 6 cases and partial in 1. Successful anatomical results were achieved ultimately in all of these cases. No patient who had erections preoperatively was impotent afterward. One child has been totally incontinent since the accident and 3 others have stress incontinence, ony 1 of whom requires treatment.