Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 2, March-April, p. 283–287

Publication type: original article

Language: English

An Evaluation of the Effectiveness of External Urethral Meatus Incision in Girls with an Anterior Deflected Urinary Stream and Symptoms of Detrusor Overactivity

Wojciech Apoznański1,A,B,C,D,E,F, Marcin Polok1,A,B,C,D,F, Jolanta Rysiakiewicz1,A,B,C,D,F, Konrad Rysiakiewicz1,A,B,C,D,F, Piotr Kolęda2,A,B,C,D,F, Krzysztof Tupikowski3,A,B,C,D,F, Tomasz Szydełko4,A,B,C,D,F, Katarzyna Kiliś-Pstrusińska5,A,E,F

1 Department and Clinic of Pediatric Surgery and Urology, Wroclaw Medical University, Poland

2 Department of Pathomorphology, Wroclaw Medical University, Poland

3 Department of Urology and Oncology, Wroclaw Medical University, Poland

4 Department of Palliative Care Nursing, Wroclaw Medical University, Poland

5 Department and Clinic of Pediatric Nephrology, Wroclaw Medical University, Poland

Abstract

Background. Urethral stenosis or abnormalities in the external urethral meatus in girls may lead to serious functional bladder outlet obstruction and recurrent urinary tract infections.
Objectives. The aim of the study was to analyze the efficacy of meatotomy in girls with an anterior deflected urinary stream (AdUS) and symptoms of detrusor overactivity.
Material and Methods. A group of 67 girls between the ages of 5 and 16 (mean age: 8.6 years) with symptoms of detrusor overactivity participated in the study. The girls were treated with oxybutinin in the years 2010−2011. The group included 37 girls with AdUS (the AdUS group) while the remaining 30 girls (the OXY group) were found to have a normal urinary stream. In the AdUS group an external urethral meatus incision was performed. The follow-up period was three months. The presence of urinary tract infections (UTI) as well as nocturnal bedwetting and daytime incontinence were analyzed before and after treatment.
Results. After three months, in the AdUS group no UTI was found in 12 children (32%) (p < 0.05), including 11 patients with prior febrile UTI (p < 0.05). Recovery from daytime urinary incontinence was observed in 20 girls (54%) and recovery from nocturnal bedwetting in 8 girls (22%). In the OXY group no infections were found in three girls (10%); recovery from daytime urinary incontinence was noted in 21 girls (70%) and from nocturnal bedwetting in 10 girls (33%).
Conclusion. Girls with symptoms of detrusor overactivity accompanied by an anterior deflected urinary stream experience UTIs and fever more often than girls with detrusor overactivity and a normal urinary stream. An incision in the external urethral meatus in girls with AdUS and detrusor overactivity seems to be effective treatment for recurrent urinary tract infections, especially febrile ones.

Key words

AdUS, meatotomy, detrusor overactivity, UTI.

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