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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Urology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1434021

Anterior Deflected Urinary Stream (ADUS) in Female Children: Description of a Unique Clinical Entity and Surgical Management

Provisionally accepted
Matthew S. Swallow Matthew S. Swallow *Cynthia A. Sharadin Cynthia A. Sharadin Anthony J. Schaeffer Anthony J. Schaeffer Deborah L. Jacobson Deborah L. Jacobson Glen A. Lau Glen A. Lau
  • University of Utah Health Care, Salt Lake City, United States

The final, formatted version of the article will be published soon.

    Objectives: To investigate the clinical presentation and outcomes for a series of female pediatric patients with severe anterior deflection of the urinary stream (ADUS) who were managed via urethromeatoplasty. Methods: This single institution retrospective cohort study used the institutional billing database to identify female patients <=18 years who received a urethromeatoplasty (CPT 53450) from 2007-2022. Patients were included if a substantial anterior deflection of their urinary stream was the primary indication for surgery. Patients were excluded if they were >18 years of age, had a history of prior genital trauma, or underwent surgery for an indication other than a deflected urinary stream. Results: 20 female patients underwent urethromeatoplasty between 2007 and 2022, with a median age of 3 years old. All patients presented with difficulty aiming the urinary stream during toilet training and demonstrated a web of tissue along the posterior aspect of the urethral orifice. 19/20 patients noted immediate response (i.e., normal, non-deflected urinary stream) after the urethromeatoplasty with no further urinary complaints. There were no post-operative complications within a 90-day period. Conclusions: ADUS is a clinical entity characterized by a web of deflecting tissue at the female posterior urethral meatus that causes severe urinary deflection without other urologic symptoms. This is not well-described in the literature. Surgical correction via urethromeatoplasty is safe and effective.

    Keywords: pediatric urology, Urethra, Lower Urinary Tract Symptoms, Surgery, Bladder

    Received: 16 May 2024; Accepted: 10 Sep 2024.

    Copyright: © 2024 Swallow, Sharadin, Schaeffer, Jacobson and Lau. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Matthew S. Swallow, University of Utah Health Care, Salt Lake City, United States

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