Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12787-12792
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12787
Interventional urethral balloon dilatation before endoscopic visual internal urethrotomy for post-traumatic bulbous urethral stricture: A case report
Ji Yong Ha, Mu Sook Lee
Ji Yong Ha, Department of Urology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, South Korea
Mu Sook Lee, Department of Radiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, South Korea
Author contributions: Ha JY and Lee MS contributed to the manuscript writing and editing and data collection and analysis; Lee MS contributed to the conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by the National Research Foundation of Korea Grant founded by the Korea Government, No. NRF-2022R1A2C1007169.
Informed consent statement: Informed written consent was obtained from the patient and his parents for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mu Sook Lee, MD, Professor, Department of Radiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-daero, Dalseo-gu, Daegu 42601, South Korea. musukilee@dsmc.or.kr
Received: October 3, 2022
Peer-review started: October 3, 2022
First decision: October 13, 2022
Revised: October 22, 2022
Accepted: November 7, 2022
Article in press: November 7, 2022
Published online: December 6, 2022
Processing time: 59 Days and 18.9 Hours
Abstract
BACKGROUND

While several treatment options are available for pediatric urethral strictures, the appropriate treatment must be based on several factors. Although endoscopic visual internal urethrotomy (EVIU) could be a first-line treatment option for short pediatric urethral strictures, it is not feasible if the urethroscope cannot pass through the stricture point. Herein, we present a pediatric case of severe post-traumatic bulbous urethral stricture that was successfully treated by EVIU after securing the urethral route via interventional balloon dilatation.

CASE SUMMARY

A 12-year-old boy presented at our outpatient clinic with the inability to urinate. He had sustained a straddle injury three months prior. The post-void residual urine volume was 644 mL, and retrograde urethrography confirmed severe stricture of the bulbous urethra. EVIU was planned; however, the first attempt to treat the stricture failed because the urethroscope could not pass through the stricture point. The urethral route was subsequently secured via balloon dilatation of the stricture, which was performed in collaboration with specialists from the department of interventional radiology. The urethroscope was then able to pass, and the repeat EVIU was successful.

CONCLUSION

Interventional urethral balloon dilatation before EVIU may help secure the urethral route in the treatment of pediatric urethral strictures.

Keywords: Urethral stricture; Endoscopic visual internal urethrotomy; Urethroplasty; Urethral balloon dilatation; Interventional radiology; Case report

Core Tip: Urethral stricture is one of the most challenging problems in urology, with traumatic and iatrogenic etiologies accounting for most cases. Appropriate treatment methods, including endoscopic management [dilation and endoscopic visual internal urethrotomy (EVIU)], urethroplasty, and urethral stenting, depend on the site and length of urethral stricture and the clinical situation. EVIU could be the first-line treatment for pediatric urethral stricture, although it is not a viable option when the urethroscope cannot pass through the stricture. Herein, we describe the successful management of a severe urethral stricture by EVIU after securing the urethral route via interventional balloon dilatation.