Evaluation of urethral traumas in children: A retrospective analysis

Abstract

Abstract Objective: The leading cause of child mortality is trauma. Urethral injuries, although rare and with low mortality rates, pose a challenging treatment process. In this study, we conducted a retrospective evaluation of cases from two centers with anterior, posterior urethral, and bladder neck injuries associated with trauma. Our aim was to discuss the obtained results in conjunction with the existing literature. Materials and Methods: A total of 14 cases with urethral and bladder neck injuries resulting from trauma were retrospectively analyzed. These cases were selected from the period between 2010 and 2015 in the first clinic, and between 2017 and 2022 in the second clinic. Parameters such as age, gender, mechanism of injury, location of urethral injury, presence of additional injuries, surgical interventions performed, and treatment outcomes were retrospectively evaluated. Results: The average age was 10.2±2.9 years (Range: 4-13 years). Motor vehicle accidents were documented in nine cases, fall down from higher places were in two cases, bicycle accidents in three cases, and injury due to clean intermittent catheterization in one case. Based on the identified localization of urethral injuries, seven cases involved bladder neck injuries, six cases had posterior urethral injuries, and one case had an anterior urethral injury. All patients were observed from their first admission to full recovery. Conclusion: Urethral injuries in childhood are considered rare traumas that often lack sufficient expertise in a single center. While most mild anterior and posterior urethral injuries in children can be managed with urethral catheterization, advanced strictures may necessitate frequent dilation and anastomotic resection. It is crucial to meticulously plan personalized treatment strategies to ensure voluntary and satisfactory voiding with appropriate calibration.