ABSTRACT
Objective
To assess uroflowmetry in the long-term follow-up of symptomatic meatal stenosis patients
prior to and following meatotomy. Severity of symptoms and treatment success has been
defined by patient history, physical examination, and witnessed voiding. Uroflowmetry
might add objective parameters for the assessment, however long-term data are lacking.
Methods
A prospective study following 25 symptomatic toilet-trained boys before and after
meatotomy was performed with short and long-term follow-up after surgery. Patient
history, physical examination, and uroflowmetry variables were recorded.
Results
Fifteen patients were fully evaluable. Mean age at operation was 6.4 years (2.5-10.5)
with an average follow-up of 43 months. All patients were symptomatic before surgery;
complete symptomatic resolution was achieved in all patients at short-term follow-up,
and in 12 at long-term follow-up. A stenotic meatus was seen in all patients before
surgery, at long-term follow-up 12 of 15 (80%) had an open appearing meatus (P = .0001). Abnormal uroflowmetry pattern was present in 8 of 15 (53%) prior to surgery
and 2 of 15 (13%) at long-term follow-up (P = .02). Normal maximal flow rate as defined by ICCS were seen in 5, 11, and 12 patients
before, 1 month after and at long-term follow-up (P = .06 and 0.02, respectively). PVR improved significantly at long-term follow-up
(P = .0012).
Conclusion
Symptom evaluation and physical examination should be the hallmark assessing children
with meatal stenosis. Clinical assessment one month after surgery suffices and long-term
follow-up is unnecessary. Uroflowmetry provides objective assessment as well as surgical
success; however, it is unnecessary since it does not change the management.
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Article info
Publication history
Published online: December 12, 2018
Accepted:
December 4,
2018
Received:
September 22,
2018
Footnotes
Author contributions: Amos Neheman: Conception and design, drafting and revising, final approval; Yishai H. Rappaport: Drafting and revising; Abd E. Darawsha: Conception and design; Ilan Leibovitch: Drafting and revising, final approval; Itay A. Sternberg: Conception and design, drafting and revising, final approval.
Conflict of interest: None of the authors has a conflict of interest.
Ethical Approval: The study protocol was approved by the medical center's ethical committee for experiments in humans.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
