after these devastating injuries. The authors are to be com-mended for their excellent report.

Gerald H. Jordan, M.D., F.A.C.S., F.A.A.P., Department ofUrology, Eastern Virginia Medical School, Norfolk, Virginia

doi:10.1016/j.urology.2008.03.062UROLOGY 72: 540–544, 2008. © 2008 Elsevier Inc.

REPLYWe greatly appreciate the interest in our article and thethoughtful comments and queries. In our series of 28 childrenwith pelvic fracture urethral distraction defects, the mean agewas 12.1 years (median 12).

We agree with the statement that the treatment of childrenaged 14-18 years is no different from that of adult patients andthat the more difficult group to treat is the prepubertal (�12years) group because of anatomic difficulties.

Of our 28 patients, 7, in whom initial perineal urethroplastyfailed, underwent a subsequent salvage procedure. In this series,the median follow-up was 36 months after the first procedure.We admit that length of follow-up after the secondary proce-dure was short and too early to report on the final success ratefor those patients who underwent placement of a facial flap witha tubed skin island repair as a salvage procedure (3 patients).However, all 7 patients who required a secondary procedure arereceiving regular follow-up and have been doing well. Probably,in the future, we will be able to provide the long-term results ofthese patients.

Manish Singla, M.S. (Urology), and Rakesh Kapoor, M.Ch.(Urology), Department of Urology and RenalTransplantation, Sanjay Gandhi Post Graduate Institute ofMedical Sciences, Lucknow, Uttar Pradesh, India

doi:10.1016/j.urology.2008.05.004UROLOGY 72: 540–544, 2008. © 2008 Elsevier Inc.

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