Urethral stenosis in baby

A baby's urethral stenosis may be caused by congenital factors or by external impact. A baby's urethral stenosis can be cured, so parents don't need to panic too much. There are now selective ways to treat baby's urethral stenosis. In the past, due to the underdeveloped science, only conservative treatment was possible. With the development of science, such diseases can be treated surgically. The surgical risks are relatively small and the cure rate is extremely high.

Congenital urethral stenosis can be dilated with instruments in mild cases, and surgical treatment is required in severe cases. However, the operation is not major. If not treated, it will often cause urinary incontinence and even reflux kidney infection, affecting kidney function. It is recommended to go to a regular hospital for examination to determine the cause and carry out symptomatic treatment in time.

It is a common phenomenon that boys have urethral stenosis. For some children, the urethral opening will gradually become looser as they grow older, but for some children, due to urethral inflammation and other reasons, the opening will not become loose but tightened instead. Therefore, when children urinate, urine cannot be discharged smoothly and will accumulate between the glans and the foreskin. Some will even form blister-like swellings. Over time, the residual substances in the urine will form smegma, balanitis and even stones.

The treatment of urethral stenosis can be conservative or surgical, depending on the condition.

The conservative treatment method mainly involves cleaning the child's glans every day, and then appropriately retracting the foreskin to make the foreskin opening gradually looser until the glans is fully visible. When using this method, you should pay attention to the fact that each time you pull up the foreskin, it should reach a level of mild pain. Do not push the foreskin up gently and repeatedly to avoid giving the child pleasure and forming bad habits. If conservative treatment for a period of time cannot fully expose the glans penis, and recurrent infections occur, surgical treatment can be chosen. This minor surgery has no age limit.

① Traumatic urethral stenosis: It is actually a late complication of urethral trauma and is the most common. ② Iatrogenic injury: mostly located between the junction of the anterior urethra, scrotum and penis to the bulbar urethra, caused by instrumentation in the urethra, urethral compression necrosis, or chemical stimulation from an indwelling urinary catheter. Recently, it has been found that damage to the urethral mucosa by pancreatic enzymes in the urine after pancreatic transplantation can cause urethral stenosis. ③ Inflammatory: Inflammatory urethral stricture is caused by specific or non-specific urethral infection. Among specific infections, gonorrheal urethral stricture is more common, followed by tuberculosis. Among non-specific infections, urethral stricture of the external urethra and penile urethra caused by repeated inflammation of the foreskin and glans is more common. ④ Congenital: Congenital stenosis of the external urethral orifice is the most common, and urethral valves, hypertrophy of the seminal vesicles, congenital narrowing of the urethral lumen, phimosis, etc. can also be seen.

Guidance: The choice of treatment for urethral stricture depends on the patient's general condition, the cause of the stricture, the location, length and density of the scar, and previous treatment history. One or more methods can be selected depending on the condition.

1. Urethral dilation: Urethral dilation plays a certain role in the treatment of stricture and has a therapeutic effect on fibrosis that only invades the epithelium or superficial corpus cavernosum. After dilation, the stenotic area is stretched and massaged, which improves local blood circulation, promotes the softening of scar tissue, and is beneficial to the healing of stenosis.

2. Endoscopic surgery: It is the first choice for treating urethral stricture. Its main advantages are safety, convenience, repeatability, few complications, short hospitalization time and wide indications. It is suitable for all types of urethral strictures, especially for those with posterior urethral strictures or those who have had open surgery but have difficulty in undergoing another open surgery.

3. Open urethroplasty: Compared with endoscopic surgery, open posterior urethroplasty has a low recurrence rate. Open urethroplasty includes end-to-end anastomosis and replacement urethroplasty. The former is divided into transperineal, transabdominal-perineal, and pubic anastomosis according to different surgical approaches, and is recognized as the most effective open surgery.

4. Memory alloy stent: This method is simple to operate, less traumatic, has a high success rate, and does not require a urinary catheter after surgery. Therefore, urination is rapid, complications are few, and the patient suffers little pain, making it easy to accept. It has a good effect on urethral strictures that are difficult to treat with other methods, but the long-term efficacy remains to be observed.

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