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Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Female urethral reconstruction is an uncommonly performed surgery to repair female urethral strictures, diverticulum, and fistulas. Because of the rarity of these operations, complications have not been well described in the literature. Complications can be categorized as intraoperative and postoperative. Postoperative can be further divided into general complications common to all pelvic surgery, which will not be discussed here, and those that are specific to urethral reconstruction. Those complications include: (1) early or late postoperative wound complications from the graft or flap harvest site, (2) stricture or fistula recurrence, (3) de novo postoperative incontinence, (4) de novo or recurrent urethral obstruction, and (5) de novo detrusor overactivity.

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References

  1. Flisser AJ, Blaivas JG. Outcome of urethral reconstructive surgery in a series of 74 women. J Urol. 2003;169(6):2246–9.

    Article  PubMed  Google Scholar 

  2. Elkins TE, DeLancey JO, McGuire EJ. The use of modified Martius graft as an adjunctive technique in vesicovaginal and rectovaginal fistula repair. Obstet Gynecol. 1990;75(4):727–33.

    CAS  PubMed  Google Scholar 

  3. Gormley EA. Vaginal flap urethroplasty for female urethral stricture disease. Neurourol Urodyn. 2010;29(Suppl 1):S42–5.

    Article  PubMed  Google Scholar 

  4. Tanello M, Frego E, Simeone C, Cosciani Cunico S. Use of pedicle flap from the labia minora for the repair of female urethral strictures. Urol Int. 2002;69(2):95–8.

    Article  CAS  PubMed  Google Scholar 

  5. Blaivas JG, Purohit RS, Benedon MS, Mekel G, Stern M, Billah M, et al. Safety considerations for synthetic sling surgery. Nat Rev Urol. 2015;12(9):481–509.

    Article  PubMed  Google Scholar 

  6. Amundsen CL, Flynn BJ, Webster GD. Urethral erosion after synthetic and nonsynthetic pubovaginal slings: differences in management and continence outcome. J Urol. 2003;170(1):134–7; discussion 7.

    Google Scholar 

  7. Onol FF, Antar B, Kose O, Erdem MR, Onol SY. Techniques and results of urethroplasty for female urethral strictures: our experience with 17 patients. Urology. 2011;77(6):1318–24.

    Article  PubMed  Google Scholar 

  8. Onol FF, Onol SY, Tahra A, Boylu U. Ventral inlay labia minora graft urethroplasty for the management of female urethral strictures. Urology. 2014;83(2):460–4.

    Article  PubMed  Google Scholar 

  9. Tsivian A, Sidi AA. Dorsal graft urethroplasty for female urethral stricture. J Urol 2006;176(2):611–3; discussion 3.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  11. Rehder P, Glodny B, Pichler R, Exeli L, Kerschbaumer A, Mitterberger MJ. Dorsal urethroplasty with labia minora skin graft for female urethral strictures. BJU Int. 2010;106(8):1211–4.

    Article  PubMed  Google Scholar 

  12. Montorsi F, Salonia A, Centemero A, Guazzoni G, Nava L, Da Pozzo LF, et al. Vestibular flap urethroplasty for strictures of the female urethra. Impact on symptoms and flow patterns. Urol Int. 2002;69(1):12–6.

    Article  PubMed  Google Scholar 

  13. O’Connell HE, DeLancey JO. Clitoral anatomy in nulliparous, healthy, premenopausal volunteers using unenhanced magnetic resonance imaging. J Urol. 2005;173(6):2060–3.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Park JM, Hendren WH. Construction of female urethra using buccal mucosa graft. J Urol. 2001;166(2):640–3.

    Article  CAS  PubMed  Google Scholar 

  15. Berglund RK, Vasavada S, Angermeier K, Rackley R. Buccal mucosa graft urethroplasty for recurrent stricture of female urethra. Urology. 2006;67(5):1069–71.

    Article  PubMed  Google Scholar 

  16. Bhargava S, Chapple CR. Buccal mucosal urethroplasty: is it the new gold standard? BJU Int. 2004;93(9):1191–3.

    Article  CAS  PubMed  Google Scholar 

  17. Souza GF, Calado AA, Delcelo R, Ortiz V, Macedo Jr A. Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits. Int Braz J Urol. 2008;34(3):345–51; discussion 51–4.

    Google Scholar 

  18. Dublin N, Stewart LH. Oral complications after buccal mucosal graft harvest for urethroplasty. BJU Int. 2004;94(6):867–9.

    Article  PubMed  Google Scholar 

  19. Kamp S, Knoll T, Osman M, Hacker A, Michel MS, Alken P. Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek? BJU Int. 2005;96(4):619–23.

    Article  PubMed  Google Scholar 

  20. Wong E, Fernando A, Alhasso A, Stewart L. Does closure of the buccal mucosal graft bed matter? Results from a randomized controlled trial. Urology. 2014;84(5):1223–7.

    Article  PubMed  Google Scholar 

  21. Sharma GK, Pandey A, Bansal H, Swain S, Das SK, Trivedi S, et al. Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women. BJU Int. 2010;105(9):1309–12.

    Article  PubMed  Google Scholar 

  22. Simonato A, Gregori A, Lissiani A, Galli S, Ottaviani F, Rossi R, et al. The tongue as an alternative donor site for graft urethroplasty: a pilot study. J Urol. 2006;175(2):589–92.

    Article  PubMed  Google Scholar 

  23. Elkins TE, Ghosh TS, Tagoe GA, Stocker R. Transvaginal mobilization and utilization of the anterior bladder wall to repair vesicovaginal fistulas involving the urethra. Obstet Gynecol. 1992;79(3):455–60.

    Article  CAS  PubMed  Google Scholar 

  24. Blaivas JG, Sandhu J. Urethral reconstruction after erosion of slings in women. Curr Opin Urol. 2004;14(6):335–8.

    Article  PubMed  Google Scholar 

  25. Blaivas JG, Santos JA, Tsui JF, Deibert CM, Rutman MP, Purohit RS, et al. Management of urethral stricture in women. J Urol. 2012;188(5):1778–82.

    Article  PubMed  Google Scholar 

  26. Clemens JQ, DeLancey JO, Faerber GJ, Westney OL, McGuire EJ. Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology. 2000;56(4):589–94.

    Article  CAS  PubMed  Google Scholar 

  27. Blaivas JG, Heritz DM. Vaginal flap reconstruction of the urethra and vesical neck in women: a report of 49 cases. J Urol. 1996;155(3):1014–7.

    Article  CAS  PubMed  Google Scholar 

  28. Petrou SP, Jones J, Parra RO. Martius flap harvest site: patient self-perception. J Urol. 2002;167(5):2098–9.

    Article  PubMed  Google Scholar 

  29. Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183(5):1906–14.

    Article  PubMed  Google Scholar 

  30. Blaivas JG, Chaikin DC. Pubovaginal fascial sling for the treatment of all types of stress urinary incontinence: surgical technique and long-term outcome. Urol Clin North Am. 2011;38(1):7–15, v.

    Google Scholar 

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Acknowledgment

The authors gratefully acknowledge the contribution of Dorota (Borawski) Witulska, M.D., who coauthored the prior edition of this chapter.

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Correspondence to Rajveer S. Purohit M.D., M.P.H. .

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Purohit, R.S., Blaivas, J.G. (2017). Female Urethral Reconstructive Surgery. In: Goldman, H. (eds) Complications of Female Incontinence and Pelvic Reconstructive Surgery. Current Clinical Urology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-49855-3_19

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  • DOI: https://doi.org/10.1007/978-3-319-49855-3_19

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  • Publisher Name: Humana Press, Cham

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