Role of visual internal urethrotomy in pediatric urethral strictures.

PURPOSE: To evaluate the efficiency of visual internal urethrotomies (VIUs) in pediatric patients. PATIENTS AND METHODS: Thirty-four patients aged 0.2-16.3 years were treated with VIUs as a primary treatment for urethral stricture at our institution during 1980-2010. The stricture characteristics and need for repeat treatments as well as the results of repeat VIUs or dilatations were evaluated in a long-term follow-up. RESULTS: Each time first VIUs or repeat treatments were carried out there was a 22-33% success rate at 5 years. Twenty-four patients (71%) were treated successfully after repeat VIUs or dilatations at a median of 6.6 years' follow-up. None of the five patients with strictures longer than 2 cm were successfully treated, compared with 24 of 29 patients with shorter strictures (p = 0.001). However, stricture etiology or location did not have an impact on success. Currently four patients have undergone an open operation because of stricture and six patients are on a home dilatation program. CONCLUSION: Single VIU is successful for about one-quarter of pediatric patients with a urethral stricture. With repeated VIUs or dilatations 71% of the patients can achieve success. In strictures less than 2 cm, up to three VIUs can be attempted, but longer strictures need open correction if the patient does not wish to follow the home dilatation program.