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Outcome of female urethral reconstruction: a 12-year experience

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Abstract

Introduction and hypothesis

To report our experience over 12 years in female urethral reconstruction with either anterior bladder tube (Tanagho) or labia minora pedicled tube.

Patients and methods

This retrospective study included 16 patients with posttraumatic urethral loss. The patients were divided into two groups. Group I: included 6 patients managed with combined vaginal and abdominal approach using a proximally based anterior bladder tube (Tanagho) and Group II: included 10 patients underwent repair with labial fat pad flap with concomitant TOT sling. Outcomes included the success or failure of anatomical repair and continence, which was assessed during patient follow up by voiding diary, 24-h pad test and uroflowmetry.

Results

A total of 15 patients were followed for a mean of 42 months postoperatively, and only one patient was lost to follow up. Total continence was achieved in 10 patients (66.6 %) [4/6 patients (66.6 %) in group I and 6/9 patients (66.6 %) in group II]. Partial continence (i.e., one or two pad per day) was achieved in 2 patients (13.3 %). Failure occurs in 3 cases (20 %) [one case in group I and two cases in group II]. All our patients had a smooth postoperative course. In the labia pedicled tube, meatal stenosis was encountered in one patient and transient postoperative urine retention in 2 patients. Successful anatomical repair was achieved in all our patients.

Conclusion

Both Bladder tube and labia minora pedicled tube with sling procedure have high success rate with only minor complications and are equally effective in the management of females with total urethral loss. Due to the small number of patients in this study, we still need to extend our study to verify our results.

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References

  1. Hemal AK, Dorairajan LN, Gupta NP (2000) Posttraumatic complete and partial loss of urethra with pelvic fracture in girls: an appraisal of management. J Urol 163:282–287

    Article  PubMed  CAS  Google Scholar 

  2. Flisser AJ, Blaivas JG (2003) Outcome of urethral reconstructive surgery in a series of 74 women. J Urol 169:2246–2249

    Article  PubMed  Google Scholar 

  3. Tanagho EA (1981) Bladder neck reconstruction for total urinary incontinence: 10 years experience. J Urol 125:321–326

    PubMed  CAS  Google Scholar 

  4. Blaivas JG, Heritz DM (1996) Vaginal flap reconstruction of the urethra and vesical neck in women: a report of 49 cases. J Urol 155:1014–1017

    Article  PubMed  CAS  Google Scholar 

  5. Tanello M, Frego E, Simeone C, Cosciani Cunico S (2002) Use of pedicle flap from the labia minora for the repair of female urethral strictures. Urol Int 69:95–98

    Article  PubMed  CAS  Google Scholar 

  6. Migliari R, Leone P, Berdondini E, De Angelis M, Barbagli G, Palminteri E (2006) Dorsal buccal mucosa graft urethroplasty for female urethral strictures. J Urol 176:1473–1476

    Article  PubMed  Google Scholar 

  7. Zorn KC, Bzrezinski A, St-Denis B, Corcos J (2007) Female neo-urethral reconstruction with a modified neurovascular pudendal thigh flap (Singapore flap): initial experience. Can J Urol 14:3449–3454

    PubMed  Google Scholar 

  8. Kozlow JH, Chang DW (2012) Female urethral reconstruction using a tubed rectus abdominis myocutaneous flap. J Reconstr Microsurg 28:371–373

    PubMed  Google Scholar 

  9. Blaivas JG, Purohit RS (2008) Post-traumatic female urethral reconstruction. Curr Urol Rep 9:397–404

    Article  PubMed  Google Scholar 

  10. Venn SN, Greenwell TJ, Mundy AR (1999) Pelvic fracture injuries of the female urethra. BJU Int 83:626–630

    Article  PubMed  CAS  Google Scholar 

  11. Perry MO, Husmann DA (1992) Urethral injuries in female subjects following pelvic fractures. J Urol 147:139–143

    PubMed  CAS  Google Scholar 

  12. Orkin LA (1991) Trauma to the bladder u, and kidney. In: Sciarra JJ (ed) Gynecology and obstetrics, chap 88. JB Lippincott, Philadelphia

    Google Scholar 

  13. Hendren WH (1980) Construction of female urethra from vaginal wall and a perineal flap. J Urol 123:657–664

    PubMed  CAS  Google Scholar 

  14. Blaivas JG (1991) Treatment of female incontinence secondary to urethral damage or loss. Urol Clin North Am 18:355–363

    PubMed  CAS  Google Scholar 

  15. Blaivas JG (1989) Vaginal flap urethral reconstruction: an alternative to the bladder flap neourethra. J Urol 141:542–545

    PubMed  CAS  Google Scholar 

  16. Xu YM, Sa YL, Fu Q, Zhang J, Xie H, Jin SB (2009) Transpubic access using pedicle tubularized labial urethroplasty for the treatment of female urethral strictures associated with urethrovaginal fistulas secondary to pelvic fracture. Eur Urol 56:193–200

    Article  PubMed  Google Scholar 

  17. Wadie BS, Elhifnawy A, Khair AA (2007) Reconstruction of the female urethra: versatility, complexity and aptness. J Urol 177:2205–2210

    Article  PubMed  Google Scholar 

  18. Hamlin RH, Nicholson EC (1969) Reconstruction of urethra totally destroyed in labour. Br Med J 2:147–150

    Article  PubMed  CAS  Google Scholar 

  19. Fall M (1995) Vaginal wall bipedicled flap and other techniques in complicated urethral diverticulum and urethrovaginal fistula. J Am Coll Surg 180:150–156

    PubMed  CAS  Google Scholar 

  20. Falandry L, Xie D, Liang Z, Seydou M, Alphonsi R (1999) Utilization of a pedicled labial flap, single or double face, for the management of post-obstetric urethral damage. J Gynecol Obstet Biol Reprod (Paris) 28:151–161

    CAS  Google Scholar 

  21. Elkins TE, Ghosh TS, Tagoe GA, Stocker R (1992) Transvaginal mobilization and utilization of the anterior bladder wall to repair vesicovaginal fistulas involving the urethra. Obstet Gynecol 79:455–460

    Article  PubMed  CAS  Google Scholar 

  22. Mundy AR (1989) Urethral substitution in women. Br J Urol 63:80–83

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This research received no specific grant from any funding agency in the public, commercial, or not for profit sectors.

Conflict of interest

The authors declare no conflicts of interest in preparing this article.

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Correspondence to M. G. Soliman.

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Radwan, M.H., Abou Farha, M.O., Soliman, M.G. et al. Outcome of female urethral reconstruction: a 12-year experience. World J Urol 31, 991–995 (2013). https://doi.org/10.1007/s00345-013-1087-2

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  • DOI: https://doi.org/10.1007/s00345-013-1087-2

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