{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:11Z","timestamp":1753891871624,"version":"3.41.2"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single institution retrospective cohort study used the institutional billing database to identify female patients \u226418 years who received a urethromeatoplasty (CPT 53450) from 2007 to 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 &amp;gt;18 years of age, had a history of prior genital trauma, or underwent surgery for an indication other than a deflected urinary stream.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1434021","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T04:30:11Z","timestamp":1727238611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior deflected urinary stream in female children: description of a unique clinical entity and surgical management"],"prefix":"10.3389","volume":"12","author":[{"given":"Matthew S.","family":"Swallow","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia A.","family":"Sharadin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Schaeffer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah L.","family":"Jacobson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen A.","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/S0031-3955(05)70549-6","article-title":"Common office problems in pediatric urology and gynecology","volume":"44","author":"Brown","year":"1997","journal-title":"Pediatric Clinic North Am"},{"key":"B2","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/00006565-199602000-00018","article-title":"Treating complications of circumcision","volume":"12","author":"Baskin","year":"1996","journal-title":"Pediatr Emerg Care"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1016\/j.urology.2017.11.013","article-title":"Congenital stenosis of the external orifice of the urethra in a female child","volume":"112","author":"Shi","year":"2018","journal-title":"Urology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/S0022-5347(17)63782-0","article-title":"Distal urethral stenosis in little girls","volume":"93","author":"Lyon","year":"1965","journal-title":"J Urol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1111\/j.1464-410X.1999x.00929.x","article-title":"Anomalies of the external urethral meatus in girls with non-neurogenic bladder sphincter dysfunction","volume":"83","author":"Hoebeke","year":"1999","journal-title":"BJU Int"},{"key":"B6","doi-asserted-by":"publisher","first-page":"111.e1","DOI":"10.1016\/j.jpurol.2015.10.002","article-title":"Labial adhesions and urinary tract problems: the importance of genital examination","volume":"12","author":"Melek","year":"2016","journal-title":"J Pediatr Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1002\/nau.22204","article-title":"Urethral meatus deformities in girls as a factor in dysfunctional voiding","volume":"31","author":"Klijn","year":"2012","journal-title":"Neurourol Urodyn"},{"key":"B8","doi-asserted-by":"publisher","first-page":"283","DOI":"10.17219\/acem\/37079","article-title":"An evaluation of the effectiveness of external urethral meatus incision in girls with an anterior deflected urinary stream and symptoms of detrusor overactivity","volume":"23","author":"Apoznanski","year":"2014","journal-title":"Adv Clin Exp Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1016\/j.juro.2014.01.110","article-title":"The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the international children\u2019s continence society","volume":"191","author":"Austin","year":"2014","journal-title":"J Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/j.jpurol.2017.08.008","article-title":"Anterior deflected urinary stream","volume":"13","author":"Abbas","year":"2017","journal-title":"J Pediatr Urol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1434021\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T04:30:13Z","timestamp":1727238613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1434021\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,25]]},"references-count":10,"alternative-id":["10.3389\/fped.2024.1434021"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1434021","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2024,9,25]]},"article-number":"1434021"}}