K M McKertich | PubMed Health

PubMed2001

Urethral trauma in children.

We report our 12-year experience in the management of urethral injuries in nine children, six boys and three girls. The most common mechanisms of injury were motor vehicle accidents, followed by straddle injuries. All the injuries in boys involved the anterior urethra, and in girls the proximal or mid-urethra. There were associated injuries in five, including three pelvic fractures. All children were investigated with a retrograde urethrogram. Four were treated non-operatively with insertion of a urethral catheter. Of the remaining five, one had drainage of a penile haematoma, one cystourethroscopy, two insertion of urinary and suprapubic catheters, and one open cystotomy and passage of a guide wire with antegrade passage of a urethral catheter. Complications included one urinary tract infection, one urethral fistula, one urethrovaginal fistula, and two urethral strictures. Final outcome was satisfactory in all nine children.

Adolescent↗

PubMed1998

Common urological problems in women.

BACKGROUND: Significant advances in the management of some common urinary problems have occurred in recent years. Problems that are likely to present to the general practitioner include urinary incontinence, voiding dysfunction, recurrent bacterial cystitis and interstitial cystitis. OBJECTIVE: The aim of this article is to highlight the advances that have occurred in the management of these common problems and their management strategy in the primary care setting. DISCUSSION: The management of incontinence, particularly stress urinary incontinence includes an accurate diagnosis and treatment tailored to the condition identified. Urinary incontinence due to the overactive and/or underactive bladder is more difficult to cure but significant improvement can be achieved in the majority of people. While severe incontinence requires an accurate diagnosis, non-operative strategies without a urodynamic diagnosis can be used in the treatment of milder forms. It is important to obtain an accurate diagnosis when the patient is not improving with conservative strategies. The problem of recurrent bacterial infections is common in women of all ages but cure should be possible in the majority of affected women. While the enigmatic entity of interstitial cystitis is increasingly recognised in out patients the exact basis for this condition remains obscure. Symptomatic improvement is achievable to a variable degree in most patients.

Adult↗