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Table 2 Treatment modalities in children with urethral prolapse

From: Conservative approach for the treatment of urethral prolapse in children: case report and literature review of 278 pediatric cases

Source Participants No. Non-surgical treatment Surgical treatment
Type of treatment Indication Outcome Follow-up duration Type of treatment Indication Outcome Follow-up duration
Zhang et al. (2020/China) [7] n = 8 Conservative treatment = 7 (no details) First line = 7 Successful = 7 NR Surgical resection = 1 First line = 1 Successful = 1 NR
Novoa-Carballal et al. (2018/Spain) [20] n = 1 Conservative treatment = 1 (no details) First line = 1 Successful with mild prolapse = 1 NR None None None None
McCaskill et al. (2018/USA) [4] n = 1 TEC = 1 First line = 1 Successful = 1 1 m None None None None
Wei et al. (2017/China) [3] n = 89 Sitz baths + local ATB + steroids antispasmodic + urinary tract decontamination + manipulative reduction = 89 First line = 89 Successful = 14
unsuccessful = 75 (treated surgically)
1–16 y Surgical excision = 20
Ligation over Foley catheter = 55
Failure of conservative treatment = 75 Successful = 75 1–16 y
Liu et al. (2017/China) [6] n = 7 antiinflammation therapy + perineum nursing + sitz bath + Cath = 2 First line = 2 Successful = 2 6 y Catheter + Loop excision + Suturing with Vicryl 6/0 sutures + Local gauze packing = 5 First line = 5 Successful = 5 2 w—5 y
Lora et al. (2017/Italy) [14] n = 1 TEC + oral polyethylene glycol for constipation = 1 First line = 1 Unsuccessful = 1 (referred to urologist) 10 m None None None None
Kondamudi et al. (2014/USA) [19] n = 1 TEC = 1 First line = 1 NR NR None None None None
Ballouhey et al. (2014/France) [1] n = 28 sitz baths + anti-inflammatories = 14 First line = 14 Successful = 9 Unsuccessful = 5 (treated surgically) 1–52 m Catheter + 6 holding sutures + 4 stay & temporary holding sutures in each quadrant + resection with cautery + intervening tissue sutured with two stitches. = 19 First line = 14
Failure of conservative treatment = 5
Successful = 19 1–52 m
Ballouhey et al. (2013/France) [15] n = 1 sitz bath + local steroids for 3 days = 1 First line = 1 Unsuccessful = 1 (treated surgically) 6 m Resection by electrocoagulation around a Foley-type probe + suture with separate points = 1 Failure of conservative treatment = 1 Successful = 1 6 m
Holbrook et al. (2011/UK) [8] n = 21 Sitz bath = 13 First line = 13 Successful = 13 NR Reduction under a general anaesthetic = 8 First line = 8 Successful = 3
Recurrence = 1
Partial reduction = 2
Minimal residual prolapse = 2
NR
Aprile et al. (2011/Italy) [2] n = 1 Rest = 1 First line = 1 Successful = 1 (recurred after 2 y) 2 y Surgical excision Recurrence = 1 NR NR
Fiogbe et al. (2011/Benin) [12] n = 9 Povidone iodine + Prophylactic ATB + anti-inflammatories = 3 First line = 3 Successful = 3 10 d Foley’s urethra catheter + circumferential resection + muco-mucous suture = 6 First line = 6 Recurrence = 1 (treated again)
Successful = 5
20 m
Vunda et al. (2011/Switzerland) [16] n = 1 TEC (promestriene) + sitz baths + camomile = 1 First line = 1 Successful = 1 6 w + 20 m None None None None
Pereira et al. (2011/UK) [17] n = 1 TEC, Sitz bath = 1 First line = 1 Unsuccessful = 1 (referred to urologists) 4 w None None None None
Ekenze wt al. (2009/Nigeria) [10] n = 3 TEC = 3 First line = 3 Unsuccessful = 3 (treated surgically) 6–17 m Excision + seromucosal stitching = 3 Failure of medical treatment = 3 Successful = 3 NR
Hillyer et al. (2009/USA) [5] n = 34 TEC, Sitz bath = 6 First line = 6 Loss of follow-up = 4 unsuccessful = 2 (treated surgically) NR Foley’s urethra catheter + circumferential resection + catgut sutures = 30 Failure of medical treatment = 2
First line = 28
Successful = 30 1 m
Agarwal et al. (2008/UK) [9] n = 2 Manual reduction + Cath = 1 First line = 1 NR NR Four-quadrant excision = 1 (another case) First line = 1 NR NR
Shurtleff et al. (2002/USA) [13] n = 3 Sitz bath = 3 First line = 3 Unsuccessful = 3 (treated surgically) 7 d Four-quadrant excision = 3 Failure of medical treatment = 3 Successful = 3 2 w
8 m—2 y
Silva-Anoma et al. (2001/Ivory Cost) [11] n = 65 Amoxicilline, Metronidazol + Morniflumate + Polyvidone iode = 12 First line = 12 Successful = 3
NR = 9
1 y Doria technique = 38
Cath + excision + sutures = 15
First line = 53 Successful = 53 1 y
McKenna et al. (1999/Queensland) (18) n = 1 TEC and steroid cream = 1 First line = 1 Unsuccessful = 1 (treated surgically) 4 m Foley’s urethra catheter + circumferential resection + epithelium suture = 1 Failure of medical treatment = 1 Successful = 1 18 m
  1. Abbreviations: w, week; m, month; y, year; first line, the first treatment choice; TEC, topical estrogen cream; ATB, antibiotics; Cath, catheterization; No, number; NR, not reported