Female Urethral Strictures: Review of Diagnosis, Etiology, and Management
Purpose of Review
In this review, we describe the incidence, diagnosis, and management of urethral strictures in women.
Definitive repair of urethral strictures in women traditionally utilizes vaginal and labial flaps. Oral mucosal buccal graft urethroplasty also has high success rates, with larger series demonstrating feasibility and durability.
Urethral strictures in women are very rare. When they do occur, they are often difficult to diagnose, requiring a high index of suspicion. Women with urethral strictures often present with symptoms of obstructed urinary flow, such as incomplete emptying, straining, and elevated postvoid residual. First line, minimally invasive treatment consists of urethral dilation and urethrotomy, though urethrotomy is rarely performed. Repeat urethral dilation has low success rates compared with urethroplasty, which is a more definitive treatment.
Keywordsfemale urethral strictures reconstruction urethral strictures
Compliance with Ethical Standards
Conflict of Interest
Nnenaya Agochukwu-Mmonu, Sudarshan Srirangapatanam, Andrew Cohen, and Benjamin Breyer each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 7.•• Spilotros M, Malde S, Solomon E, Grewal M, Mukhtar BM, Pakzad M, et al. Female urethral stricture: a contemporary series. World J Urol. 2017;35(6):991–5 A retrospective study of 26 women with urethral stricture. In this study, urethral dilation, urethotomy, meatoplasty, and urethroplasty were used to treat urethral strictures. Of treatments, patients treated with buccal mucosal graft urethroplasty had the most durable result.CrossRefGoogle Scholar
- 10.•• Hampson LA, Myers JB, Vanni AJ, Virasoro R, Smith TG 3rd, Capiel L, et al. Dorsal buccal graft urethroplasty in female urethral stricture disease: a multi-center experience. Transl androl and urol. 2019;8(Suppl 1):S6–s12 Largest retrospective study of buccal mucosal grafts for female urethral stricture. In this review, most women had undergone prior stricture-related procedure, 18% of individuals had complications within 30 days, and 23% had stricture recurrence.CrossRefGoogle Scholar
- 11.J. Anast SBB, C. Klutke. Female urethral reconstruction: Humana Press; 2008.Google Scholar
- 24.Theisen KM, Kadow BT, Rusilko PJ. Three-dimensional imaging of urethral stricture disease and urethral pathology for operative planning. Curr urol rep. 2016;17(8):54.Google Scholar
- 26.Standring S. In: Standring S, editor. Gray’s anatomy: the anatomical basis of clinical practice. New York: Elsevier Limited; 2016.Google Scholar
- 28.A.P. Cameron CL-G, E.J.McGuire. Pubovaginal fascial slings: Lippincott Williams and Wilkins.Google Scholar