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Substitution Urethroplasty in Female Urethral Stricture — Our Initial Experience

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Abstract

This study is to compare different substitutional urethroplasties in female urethral stricture (FUS). FUS constitutes 4–13% of patients, with voiding symptoms, commonly treated by urethral dilatation or internal urethrotomy with a poor success rate. A urethral reconstruction is a viable option. We compared the results of different substitutional urethroplasty for the stricture urethra in females. Symptoms identified FUS. Urethral calibration (unable to pass 8 Fr catheter) and urinary flow rate of less than 12 ml per second were taken as inclusion criteria. Substitution urethroplasty was performed using vaginal ventral onlay flap vaginal dorsal graft (n = 8), dorsal buccal mucosa (n = 8), and labial skin grafts (n = 4) over 3 years. Twenty patients with urethral stricture were identified (mean age of 49.9 years). We found a good stream immediately after removing the catheter in all vaginal flap patients with post-void dribbling. With the three vaginal graft patients (75%), six buccal mucosa graft patients (75%), and two patients (50%) in the labia minora graft, 14 Fr catheter calibration is accessible in all patients except 50% of patients of the labia minora group on 1st follow-up. They require repeated dilatation. Uroflowmetry at six months showed normal flow in all vaginal flap/ graft patients and buccal mucosa grafts, while only 50% of labia minora grafts showed mild improvement. Urethroplasty using dorsal onlay buccal mucosa and vaginal graft gives the best results in women. The vaginal wall can be used safely in nonavailability of buccal mucosa. Labia minora grafts showed poor results.

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Data Availability

Data is available with corresponding author.

Abbreviations

FUS:

Woman urethral stricture

KUB:

Kidney ureter bladder

References

  1. Groutz A, Blaivas JG, Chaikin DC (2000) Bladder outlet obstruction in women: definition and characteristics. NeurourolUrodyn 19:213–220

    CAS  Google Scholar 

  2. Kuo HC (2005) Videourodynamic characteristics and lower urinary tract symptoms of woman bladder outlet obstruction. Urology 66:1005–1009

    Article  PubMed  Google Scholar 

  3. Faiena I, Koprowski C, Tunuguntla H (2016) Woman urethral reconstruction. J Urol 195:557–567

    Article  PubMed  Google Scholar 

  4. Santucci RA, Payn CK, Saigal CS (2008) Office dilation of the woman urethra: a quality of care problem in the field of urology. J Urol 180:2068

    Article  PubMed  PubMed Central  Google Scholar 

  5. Osman NI, Mangera A, Chapple CR (2013) A systematic review of surgical techniques used in the treatment of woman urethral stricture. Eur Urol 64:965–973

    Article  PubMed  Google Scholar 

  6. Kowalik C, Stoffel JT, Zinman L, Vanni AJ, Buckley JC (2014) Intermediate Outcomes After Woman Urethral Reconstruction: Graft vs Flap. Urology 83:1181–1185

    Article  PubMed  Google Scholar 

  7. Rehder P, Glodny B, Pichler R et al (2010) Dorsal urethroplasty with labia minora skin graft for woman urethral strictures. BJU Int 106:1211–1214

    Article  PubMed  Google Scholar 

  8. Sharma GK, Pandey A, Bansal H et al (2009) Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women. BJUInt 105:1309–1312

    Article  Google Scholar 

  9. Ackerman AL, Blaivas J, Anger JT (2010) Woman urethral reconstruction. Curr Bladder Dysfunct Rep. 5:225–232

    Article  PubMed  PubMed Central  Google Scholar 

  10. EscribanoPatiño G, Husillos Alonso A, Rodriguez Fernandez E, Cancho Gil MJ, Hernandez Fernandez C (2014) Urethral stricture in women. Arch Esp Urol 67:129–37

    Google Scholar 

  11. Petrou SP, Rogers AE, Parker AS et al (2012) Dorsal vaginal graft urethroplasty for woman urethral stricture disease. BJU Int 110:E1090–E1095. https://doi.org/10.1111/j.1464-410X.2012.11233

    Article  PubMed  Google Scholar 

  12. Onol FF, Antar B, Kose O et al (2011) Techniques and results of urethroplasty for woman urethral strictures: our experience with 17 patients. Urology 77:1318

    Article  PubMed  Google Scholar 

  13. Berglund RK, Vasavada S, Angermeier K et al (2006) Buccal mucosa graft urethroplasty for recurrent stricture of woman urethra. Urology 67:1069

    Article  PubMed  Google Scholar 

  14. Blaivas JG, Santos JA, Tsui JF et al (2012) Management of urethral stricture in women. J Urol 188:1778–1782

    Article  PubMed  Google Scholar 

  15. Devine PC, Wendelken JR, Devine CJ Jr (1979) Free full thickness skin graft urethroplasty: current technique. J Urol 121(3):282–285

    Article  CAS  PubMed  Google Scholar 

  16. Barbagli G, Kulkarni SB, Fossati N et al (2014) Long-term followup and deterioration rate of anterior substitution urethroplasty. J Urol 192(3):808–813

    Article  PubMed  Google Scholar 

  17. Das SK, Kumar A, Sharma GK et al (2009) Lingual mucosal graft urethroplasty for anterior urethral strictures. Urology 73(1):105–108

    Article  PubMed  Google Scholar 

  18. Mangera A, Patterson JM, Chapple CR (2011) A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol 59:797–814

    Article  PubMed  Google Scholar 

  19. Figler BD, Malaeb BS, Dy GW, Voelzke BB, Wessells H (2013) Impact of graft position on failure of single-stage bulbar urethroplasties with buccal mucosa graft. Urology 82:1166–1170

    Article  PubMed  Google Scholar 

  20. Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M (2005) Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol 174:955–958

    Article  PubMed  Google Scholar 

  21. Singh M, Kapoor R, Kapoor D et al (2013) Dorsal onlay vaginal graft urethroplasty for woman urethral stricture. Indian J Urol 29(2):124–128

    Article  PubMed  PubMed Central  Google Scholar 

  22. Castillo OA, Sepulveda F, Feria-Flores MA (2011) Urethroplasty with dorsal oral mucosa graft in woman urethral stenosis. Actas Urol Esp 35:246–249

    Article  CAS  PubMed  Google Scholar 

  23. Simonato A, Varca V, Esposito M, Carmignani G (2010) Vaginal flap urethroplasty for wide woman stricture disease. J Urol 184(4):1381–1385

    Article  PubMed  Google Scholar 

  24. Migliari R, Leone P, Berdondini E, De Angelis M, Barbagli G, Palminteri E (2006) Dorsal buccal mucosa graft urethroplasty for woman urethral strictures. J Urol 176(4 Pt 1):1473–6

    Article  PubMed  Google Scholar 

  25. Nayak P, Mandal S, Das M (2019) Ventral-inlay buccal mucosal graft urethroplasty for woman urethral stricture. Indian J Urol 35:273–277

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kore RN, Martins FE (2022) Dorsal onlay urethroplasty using buccal mucosal graft and vaginal wall graft for woman urethral stricture - Outcome of two-institution study. Indian J Urol 38(2):140–145

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hoag N, Chee J (2017) Surgical management of woman urethral strictures. Transl Androl Urol 6(Suppl 2):S76–S80

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, N.S.C.B. Medical College and Hospital, Jabalpur, M.P., India

    Shabbir Hussain, Fanindra Singh Solanki, Deepti B. Sharma, Pawan Agarwal & Dhananjay Sharma

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  1. Shabbir Hussain
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  2. Fanindra Singh Solanki
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  3. Deepti B. Sharma
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  4. Pawan Agarwal
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  5. Dhananjay Sharma
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Contributions

S H: concept, design, data acquisition. FSS: concept, design, data acquisition. DBS: literature search, manuscript preparation. P A: manuscript editing. DS: manuscript review. All authors have read and approved the manuscript.

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Correspondence to Deepti B. Sharma.

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Ethical approval was taken from Peer review committee of Institution. There is no conflict in interest. Informed consent was taken from every patient.

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The authors declare no competing interests.

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Hussain, S., Solanki, F.S., Sharma, D.B. et al. Substitution Urethroplasty in Female Urethral Stricture — Our Initial Experience. Indian J Surg (2024). https://doi.org/10.1007/s12262-024-04036-7

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  • DOI: https://doi.org/10.1007/s12262-024-04036-7

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