Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector123110.17816/psaic1231Case reportsКлинические случаиResearch ArticleAtypically extended post-traumatic stricture of the bulbous urethra in a teenager: a Case reportАтипично протяженная посттравматическая стриктура бульбозной уретры у подростка: клиническое наблюдениеhttps://orcid.org/0000-0002-9916-419X8980-7760LadyginaElizaveta A.ЛадыгинаЕлизавета Александровна
Russian Federation

Postgraduate Student

аспирант

doc.lizaladygina@yandex.ruhttps://orcid.org/0000-0001-7815-4825NikolaevVasily V.НиколаевВасилий Викторович
Russian Federation

Dr. Sci. (Med.), Professor

д-р мед. наук, профессор

vasnik@yandex.ruhttps://orcid.org/0000-0001-7508-50192757-6028DeminNikita V.ДеминНикита Валерьевич
Russian Federation

Cand. Sci. (Med.), Senior Researcher, Associate Professor

канд. мед. наук, старший научный сотрудник, доцент кафедры эндоурологии

doc.lizaladygina@yandex.ruClinical and Research Institute of Emergency Pediatric Surgery and TraumaНаучно-исследовательский институт неотложной детской хирургии и травматологииPirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаPeoples’ Friendship University of RussiaРоссийский университет дружбы народов18052022240720221222012090902202212052022Copyright ©; 2022, Ladygina E.A., Nikolaev V.V., Demin N.V.Copyright ©; 2022, Ладыгина Е.А., Николаев В.В., Демин Н.В.2022Ladygina E.A., Nikolaev V.V., Demin N.V.Ладыгина Е.А., Николаев В.В., Демин Н.В.https://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/1231

Presentation of clinical observation of a patient with an atypically extended stricture of the bulbar urethra.

A 15-year-old boy came to the clinic with complaints of difficult and prolonged urination after an injury to the perineum and scrotum. The patient underwent a 3-fold surgical treatment for an extended stricture of the bulbous urethra. Complete recovery of the patient was achieved after repeated surgical interventions. At follow-up for 2.5 years, he urinates freely and painlessly. The average urination rate is 18 ml/s, urine tests are without deviations according to echography, and adequate emptying of the bladder is noted.

In children, a post-traumatic urethral stricture is a rare condition, and patient management has not been finalized. In most cases, the methods of operations adopted in adult patients are used. Reconstructive surgery in this patient was performed in the “cold” postoperative period. With extended strictures, preference should be given to open urethroplasty, namely, augmentation techniques using a free buccal mucosal graft.

The presented clinical case demonstrates the complexity of determining the therapeutic strategies and the surgical treatment in cases of an extended bulbous urethra stricture.

Представлен клинический случай пациента с атипично протяженной стриктурой бульбозного отдела уретры.

Мальчик, 15 лет, обратился в клинику с жалобами на затрудненное и длительное мочеиспускание после травмы промежности и мошонки. Пациенту было проведено трехкратное хирургическое лечение по поводу протяженной стриктуры бульбозной уретры. Полного выздоровления пациента удалось добиться после неоднократных хирургических вмешательств. При последующем наблюдении в течение 2,5 лет пациент мочится свободно и безболезненно, средняя скорость мочеиспускания 18 мл/c, анализы мочи без отклонений, по данным эхографии отмечено адекватное опорожнение мочевого пузыря.

У детей посттравматическая стриктура уретры — редкое состояние, и тактика лечения окончательно не определена. В большинстве случаев применяют оперативные способы, принятые у взрослых пациентов. Реконструктивная операция у данного пациента выполнена в «холодном» послеоперационном периоде. При протяженных стриктурах следует отдавать предпочтение открытой уретропластике, а именно аугментационным методикам с использованием свободного трансплантата слизистой щеки.

Представленный клинический случай демонстрирует сложность определения лечебной тактики и самого хирургического лечения при протяженной стриктуре бульбозной уретры.

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