WOFAPS 2025 8th World Congress of Pediatric Surgery

Urethral trauma in children is a rare condition. The majority of the literature is derived from studies on adult populations. To better understand this topic, we conducted a narrative review of the existing literature in children.

The objective of this study was to assess the effects of conservative management versus endoscopic management versus open reconstruction in children after urethral trauma. Primary outcomes are: continence, sexual function, stricture rate. Secondary outcomes are: need for redo surgery and quality of life

A systematic analysis of the available literature was conducted by reviewing Pubmed, EMBASE, Scopus, Web of Science and Cochrane databases for articles using the search terms “pediatric urethral trauma”, with limits: age <18yr; time limit 1990-november 2023; language English, Dutch, German, French, Turkish, Russian and Romanian; with a follow-up of at least 3 months. Exclusion criteria were hypospadias and iatrogenic urethral trauma, case reports and studies with n<5. After full text read, a total of 31 articles including 787 patients were selected for final analysis.

The quality of the available literature was low, primarily due to the retrospective design of most studies. Data about management and outcomes were inconsistent, often confusing, and difficult to interpret with no standardized reporting of the results. Open surgery was more often performed than endoscopic management. Stricture rate was around 20%. No conclusion can be drawn regarding redo surgeries. Continence rates and sexual function were generally favorable with problems often transient. Quality of life was not properly investigated due to lack of validated questionnaires in children.

Due to the significant inconsistencies in existing literature, definitive conclusions regarding the optimal management of children after urethral trauma remain elusive. To address these gaps, we propose recommendations in the reporting of future research.