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Surgical interventions in female urethral strictures: a comprehensive literature review

  • Review Article
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Abstract

Introduction and hypothesis

Female urethral stricture (FUS) is an uncommon entity. Although there is no clinical consensus on the best modality of treatment, several studies have been published describing different techniques of FUS management. We carried out a literature review of the different surgical techniques used in the management of FUS and their results.

Methods

We performed a systematic search of the PubMed and EMBASE databases and several cross-references. We grouped the data available from the studies into four general treatment categories.

Results

We reported 35 studies (488 patients) with outcome measures; 53.48% of cases were presumably idiopathic in origin. A history of prior intervention was described in 91.29% of cases. As a surgical intervention, urethral dilatation (UD) had the lowest success rate of only 41.25%. In contrast, local flaps performed better (92.54% success rate) than local or oral grafts (87.30% and 89.94%, respectively). Only 9.43% of patients experienced mild to moderate post-surgery de novo incontinence; most of them recovered with pelvic floor exercises.

Conclusion

In practice, UD is tried first for FUS, at least once, before urethroplasty. In case of failure or short recurrence following UD, urethroplasty should not be delayed. In experienced hands, urethroplasty has a better outcome.

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Abbreviations

FUS:

Female urethral stricture

UD:

Urethral dilatation

BMG:

Buccal mucosal graft

LMG:

Lingual mucosal graft

VG:

Vaginal graft

BOO:

Bladder outlet obstruction

CISC:

Clean intermittent self-catheterisation

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Authors and Affiliations

  1. Apollo Hospitals, Guwahati, India

    Joy Narayan Chakraborty

  2. Department of Urology, Kasturba Medical College, Manipal, India

    Arun Chawla

  3. Department of urology, SMS Medical College, Jaipur, India

    Nachiket Vyas

Authors
  1. Joy Narayan Chakraborty
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  2. Arun Chawla
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  3. Nachiket Vyas
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Contributions

JNC: Data collection, manuscript writing and made a substantial contribution to the concept and design of the work with drafting, acquisition, analysis and interpretation of data.

AC: Analysis and interpretation of data, manuscript editing.

NV: Data collection, revision of the manuscript, critical analysis of the manuscript content.

All three authors have participated sufficiently in the work to take public responsibility for appropriate portions of the content. All the authors have read and approved the manuscript.

Corresponding author

Correspondence to Joy Narayan Chakraborty.

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Chakraborty, J.N., Chawla, A. & Vyas, N. Surgical interventions in female urethral strictures: a comprehensive literature review. Int Urogynecol J 33, 459–485 (2022). https://doi.org/10.1007/s00192-021-04906-8

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