The association of urethrorrhagia and urethral stricture disease

Michael A. Poch, Li Ann N. Handel, Daniel M. Kaplon, Richard E. Caesar, Ross Decter, Anthony A. Caldamone

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Urethrorrhagia characterized by terminal hematuria and/or bloody spotting of the underwear between episodes of voiding is a common problem of childhood. We describe a series of boys with urethrorrhagia and associated clinical and endoscopic findings. Methods and materials: The records of boys presenting between 1990 and 2005 with urethrorrhagia were retrospectively reviewed for age, symptoms, symptom duration, physical examination, radiographic evaluation, laboratory data and endoscopic findings. Results: Of 66 boys, 50 presented with classic symptoms of terminal hematuria and/or blood spotting, and 16 with atypical symptoms who underwent cystoscopy with similar findings. Endoscopic evaluation was performed in 55 (82%) patients for prolonged symptomatology or recurrent symptoms and revealed four distinct patterns: Group 1, three (5%) patients with a normal appearing urethra; Group 2, 27 (49%) patients who were found to have inflammation or hyperemia of the bulbar urethra; Group 3, 17 (31%) cases in which there was a white membranous exudate or mucosal irregularity; and Group 4, eight (14%) patients who were found to have stricture disease on cystoscopy. Stricture developed after initial cystoscopy in six cases. Conclusion: Consistent with previous studies, a subset of patients developed urethral stricture disease after presenting with urethrorrhagia. As eight patients had a urethral stricture on initial cystoscopy, and those with strictures are clinically indistinguishable symptomatically from those without, we feel that uroflow and selective cystoscopy are important tools for the work-up of severe and persistent cases of urethrorrhagia. Group 3 may represent a population at significant risk for the development of stricture disease warranting closer follow up and evaluation. The white membranous exudate found on cystoscopy may represent a pre-stricture lesion as evidenced by four cases that subsequently developed strictures.

Original languageEnglish (US)
Pages (from-to)218-222
Number of pages5
JournalJournal of Pediatric Urology
Volume3
Issue number3
DOIs
StatePublished - Jun 1 2007

Fingerprint

Urethral Diseases
Urethral Stricture
Cystoscopy
Pathologic Constriction
Metrorrhagia
Hematuria
Exudates and Transudates
Urethra
Hyperemia
Physical Examination
Inflammation

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Urology

Cite this

Poch, M. A., Handel, L. A. N., Kaplon, D. M., Caesar, R. E., Decter, R., & Caldamone, A. A. (2007). The association of urethrorrhagia and urethral stricture disease. Journal of Pediatric Urology, 3(3), 218-222. https://doi.org/10.1016/j.jpurol.2006.07.007
Poch, Michael A. ; Handel, Li Ann N. ; Kaplon, Daniel M. ; Caesar, Richard E. ; Decter, Ross ; Caldamone, Anthony A. / The association of urethrorrhagia and urethral stricture disease. In: Journal of Pediatric Urology. 2007 ; Vol. 3, No. 3. pp. 218-222.
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abstract = "Introduction: Urethrorrhagia characterized by terminal hematuria and/or bloody spotting of the underwear between episodes of voiding is a common problem of childhood. We describe a series of boys with urethrorrhagia and associated clinical and endoscopic findings. Methods and materials: The records of boys presenting between 1990 and 2005 with urethrorrhagia were retrospectively reviewed for age, symptoms, symptom duration, physical examination, radiographic evaluation, laboratory data and endoscopic findings. Results: Of 66 boys, 50 presented with classic symptoms of terminal hematuria and/or blood spotting, and 16 with atypical symptoms who underwent cystoscopy with similar findings. Endoscopic evaluation was performed in 55 (82{\%}) patients for prolonged symptomatology or recurrent symptoms and revealed four distinct patterns: Group 1, three (5{\%}) patients with a normal appearing urethra; Group 2, 27 (49{\%}) patients who were found to have inflammation or hyperemia of the bulbar urethra; Group 3, 17 (31{\%}) cases in which there was a white membranous exudate or mucosal irregularity; and Group 4, eight (14{\%}) patients who were found to have stricture disease on cystoscopy. Stricture developed after initial cystoscopy in six cases. Conclusion: Consistent with previous studies, a subset of patients developed urethral stricture disease after presenting with urethrorrhagia. As eight patients had a urethral stricture on initial cystoscopy, and those with strictures are clinically indistinguishable symptomatically from those without, we feel that uroflow and selective cystoscopy are important tools for the work-up of severe and persistent cases of urethrorrhagia. Group 3 may represent a population at significant risk for the development of stricture disease warranting closer follow up and evaluation. The white membranous exudate found on cystoscopy may represent a pre-stricture lesion as evidenced by four cases that subsequently developed strictures.",
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Poch, MA, Handel, LAN, Kaplon, DM, Caesar, RE, Decter, R & Caldamone, AA 2007, 'The association of urethrorrhagia and urethral stricture disease', Journal of Pediatric Urology, vol. 3, no. 3, pp. 218-222. https://doi.org/10.1016/j.jpurol.2006.07.007

The association of urethrorrhagia and urethral stricture disease. / Poch, Michael A.; Handel, Li Ann N.; Kaplon, Daniel M.; Caesar, Richard E.; Decter, Ross; Caldamone, Anthony A.

In: Journal of Pediatric Urology, Vol. 3, No. 3, 01.06.2007, p. 218-222.

Research output: Contribution to journalArticle

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AU - Poch, Michael A.

AU - Handel, Li Ann N.

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AB - Introduction: Urethrorrhagia characterized by terminal hematuria and/or bloody spotting of the underwear between episodes of voiding is a common problem of childhood. We describe a series of boys with urethrorrhagia and associated clinical and endoscopic findings. Methods and materials: The records of boys presenting between 1990 and 2005 with urethrorrhagia were retrospectively reviewed for age, symptoms, symptom duration, physical examination, radiographic evaluation, laboratory data and endoscopic findings. Results: Of 66 boys, 50 presented with classic symptoms of terminal hematuria and/or blood spotting, and 16 with atypical symptoms who underwent cystoscopy with similar findings. Endoscopic evaluation was performed in 55 (82%) patients for prolonged symptomatology or recurrent symptoms and revealed four distinct patterns: Group 1, three (5%) patients with a normal appearing urethra; Group 2, 27 (49%) patients who were found to have inflammation or hyperemia of the bulbar urethra; Group 3, 17 (31%) cases in which there was a white membranous exudate or mucosal irregularity; and Group 4, eight (14%) patients who were found to have stricture disease on cystoscopy. Stricture developed after initial cystoscopy in six cases. Conclusion: Consistent with previous studies, a subset of patients developed urethral stricture disease after presenting with urethrorrhagia. As eight patients had a urethral stricture on initial cystoscopy, and those with strictures are clinically indistinguishable symptomatically from those without, we feel that uroflow and selective cystoscopy are important tools for the work-up of severe and persistent cases of urethrorrhagia. Group 3 may represent a population at significant risk for the development of stricture disease warranting closer follow up and evaluation. The white membranous exudate found on cystoscopy may represent a pre-stricture lesion as evidenced by four cases that subsequently developed strictures.

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