Construction of a neourethra in girls: follow-up results

Female urethral injuries may cause serious morbidity with loss of the entire urethra in some cases. We review the results of construction of a neourethra by the flipped anterior bladder-tube technique in five girls aged 3–18 years (mean 8 years). All had pelvic fractures and had their initial management elsewhere; four were run over by motor vehicles and one suffered a pelvic gunshot injury. Three patients came with a suprapubic cystostomy, one was totally incontinent, and another had a urethrovaginal fistula. Three had an associated vaginal injury. All five patients underwent construction of a neourethra using a flipped anterior bladder-wall tube (FABWT) and have been followed for 18–80 months (mean 44 months). All patients were continent in the daytime and three passed urine spontaneously. Two were managed by clean intermittent catheterization (CIC), one per urethram and other via a continent abdominal stoma (Mitrofanoff). The FABWT technique should be considered as an option in the management of females with severe urethral injury.