21 -12 (86) 2025 - Nizomov Sh.A. - A METHOD FOR IMPROVING SURGICAL RESULTS FOR URETHRAL OBLITATIONS AND STRICTURES IN CHILDREN

A METHOD FOR IMPROVING SURGICAL RESULTS FOR URETHRAL OBLITATIONS AND STRICTURES IN CHILDREN

Nizomov Sh.A. - Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan

Resume

Posterior urethral injuries occur in 4-19% of cases due to pelvic fractures resulting from motor vehicle accidents. Anterior urethral injuries occur due to penile trauma or penetrating wounds. The complexity of treatment is due to lifelong urinary complications, such as recurrent strictures, urinary incontinence, and erectile dysfunction. Study objective: To improve treatment outcomes for post-traumatic urethral strictures and obliterations in children using a dual-lumen drainage catheter. All 80 patients had a suprapubic cystostomy drainage system at admission. After collecting urine for bacteriological analysis, the drainage system was replaced and the urinary tract was sanitized. When urinary tract infection was controlled, surgical treatment was performed – a modified Marion-Holtzow procedure with placement of a dual-lumen catheter – IDP patent no. 05277, November 19, 2001. We used a perineal incision strictly along the midline, providing wide access to the posterior urethra. Unlike the previous incision, deepening this incision does not damage the muscles. Correct implementation of first aid algorithms for urethral injuries, careful preparation, and correct execution of surgical procedures for urethral anastomosis using a dual-lumen drainage catheter, with the appropriate selection of parenteral and topical antimicrobials, resulted in good outcomes in 98.7% of cases, including cases of repeat correction for recurrent urethral strictures and obliterations.

Keywords: method for improving surgical outcomes for urethral obliterations, urethral strictures in children, modified Marion-Holtzoff procedure, dual-lumen catheter placement.

First page

125

Last page

131

For citation:Nizomov Sh.A. - A METHOD FOR IMPROVING SURGICAL RESULTS FOR URETHRAL OBLITATIONS AND STRICTURES IN CHILDREN//New Day in Medicine 12(86)2025 125-131 https://newdayworldmedicine.com/en/new_day_medicine/12-86-2025

List of References

  1. Kitrey N.D. et al., EAU Guidelines on Urological Trauma 2016, Eur. Urol. 2016;47(1):1-15
  2. Waterloos M. et al., Journal of Pediatric Urology 2019;15(176): e1e176.e7
  3. Darren J. Bryk, Lee C. Zhao, Guideline of guidelines: a review of urological trauma guidelines. BJU Int 2016;117:226–234
  4. Нестеров С.Н, Ханалиев Б.В., Володичев В.В. и др. Хирургическое лечение пациентов со стриктурой уретры. // Вестник Национального медико-хирургического центра им. Н.И. Пирогова. 2016;11(4):84-89.
  5. Павлов В.Н., Казихинуров Р.А., Измайлов А.А., и др. Опыт лечения стриктур уретры при использовании различных видов уретропластик. // Медицинский вестник Башкортостана. 2017;12/3(69):60-62.
  6. Павлов В.Н., Казихинуров Р.А., Сафиуллин Р.И., и др. Выбор оптимального метода и способы улучшения результатов хирургического лечения у пациентов с посттравматическими, воспалительными стриктурами и облитерациями уретры. // Уральский медицинский журнал. 2017;2(146):92-95.
  7. Трапезникова М.Ф., Базаев В.В., Уренков С.Б. – Сравнительный анализ результатов открытых и эндоскопических операций при облитерациях задней уретры у мужчин. // Урология. 2004;1:47-54.
  8. Arlen A.M., Powell C.R., Hoffman H.T., Kreder K.J. Buccal mucosal graft urethroplasty in the treatment of urethral strictures: experience using the two-surgeon technique. // Scientific World Journal. 2010;8:74-79.
  9. Banks F.C., Griffin S.J., Steinbrecher H.A., Malone P.S. Aetiology and treatment of symptomatic idiopathic urethral strictures in children. // J. Pediatr. Urol. 2009;5(3):215-218.
  10. Rice-Oxley M. The urethral structure after acquired brain injure. // Clin Rehabil. 2000;14(10):548-550.
  11. Николаев В.В., Степанов Э.А. Стриктуры уретры у детей. // Москва. "Медицина". 1998; 156 стр.
  12. Шкуратов С.И. Современные способы лечения стриктур уретры. // Урология 2002; 58-59 стр.
  13. Tenke P, Kovacs B, Bjerklund Johansen TE, Matsumoto T, Tambyah PA, Naber KG. European and Asian guidelines on management and prevention of catheter associated urinary tract infections. Int J Antimicrob Agents 2008;31S:68-78.
  14. Clinical overview: Bladder and urethral injury. Edited July 18, 2019, PP24. https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-03d60fdf-97c6-454b-a02a-da9b98d550b3
  15. Хлебовец Н.И., Харченко О.Ф., Инфекции мочевой системы у детей // Журнал ГГМУ 2005;3:119-120.
  16. Бухарин О.В., Вялкова А.А., Грищенко В.А. Клинико-микробиологическое обоснование ранней диагностики пиелонефрита у детей // Российский педиатрический журнал, 2003;2:42-47.

    file

    download