Background: Urethral stenosis or abnormalities in the external urethral meatus in girls may lead to serious functional bladder outlet obstruction and recurrent urinary tract infections.
Objectives: The aim of the study was to analyze the efficacy of meatotomy in girls with an anterior deflected urinary stream (ADUS) and symptoms of detrusor overactivity.
Material and methods: A group of 67 girls between the ages of 5 and 16 (mean age: 8.6 years) with symptoms of detrusor overactivity participated in the study. The girls were treated with oxybutinin in the years 2010-2011. The group included 37 girls with ADUS (the ADUS group) while the remaining 30 girls (the OXY group) were found to have a normal urinary stream. In the ADUS group an external urethral meatus incision was performed. The follow-up period was three months. The presence of urinary tract infections (UTI) as well as nocturnal bedwetting and daytime incontinence were analyzed before and after treatment.
Results: After three months, in the ADUS group no UTI was found in 12 children (32%) (p < 0.05), including 11 patients with prior febrile UTI (p < 0.05). Recovery from daytime urinary incontinence was observed in 20 girls (54%) and recovery from nocturnal bedwetting in 8 girls (22%). In the OXY group no infections were found in three girls (10%); recovery from daytime urinary incontinence was noted in 21 girls (70%) and from nocturnal bedwetting in 10 girls (33%).
Conclusions: Girls with symptoms of detrusor overactivity accompanied by an anterior deflected urinary stream experience UTIs and fever more often than girls with detrusor overactivity and a normal urinary stream. An incision in the external urethral meatus in girls with ADUS and detrusor overactivity seems to be effective treatment for recurrent urinary tract infections, especially febrile ones.