Abstract
Urethral stricture disease and urethroplasty in females have gained recent interest with newer urethroplasty techniques being described for various types of strictures. This chapter provides an insight into evaluation and management options for a woman with urethral stricture. Female urethral stricture remains a rare disease, and the clinical presentation overlaps with other functional causes of obstruction. The diagnosis is highly dependent on actual demonstration of a fibrotic ring on endoscopy. Results of minimally invasive options are dismal beyond one attempt. Many surgical reconstruction options are now available with good reported short-term outcomes. Given the anatomical and physiological differences between male and female urethra, female urethral stricture disease leaves a lot to be desired for improving our understanding of this disease.
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References
Carr LK, Webster GD. Bladder outlet obstruction in women. Urol Clin North Am. 1996;23(3):385–92.
Faiena I, Koprowski C, Tunuguntla H. Female urethral reconstruction. J Urol. 2016;195(3):557–67.
Hoag N, Chee J. Surgical management of female urethral strictures. Transl Androl Urol. 2017;6(S2):S76–80.
Waterloos M, Verla W. Female urethroplasty: a practical guide emphasizing diagnosis and surgical treatment of female urethral stricture disease. Biomed Res Int. 2019;2019:1–13.
Osman NI, Chapple CR. Contemporary surgical management of female urethral stricture disease. Curr Opin Urol. 2015;25(4):341–5.
Gormley EA. Vaginal flap urethroplasty for female urethral stricture disease. Neurourol Urodyn. 2010;29(S1):S42–5.
Osman NI, Mangera A, Chapple CR. A systematic review of surgical techniques used in the treatment of female urethral stricture. Eur Urol. 2013;64(6):965–73.
Gleason DM, Bottaccini MR, Lattimer JK. What does the bougie a boule calibrate? J Urol. 1969;101(1):114–6.
King MW. Stricture of the female urethra. Am J Surg. 1931;13(2):251–5.
Flisser AJ, Blaivas JG. Outcome of urethral reconstructive surgery in a series of 74 women. J Urol. 2003;169(6):2246–9.
Roenneburg ML, Wheeless CR. Traumatic absence of the proximal urethra. Am J Obstet Gynecol. 2005;193(6):2169–72.
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.
Andrews HO, Shah PJ. Surgical management of urethral damage in neurologically impaired female patients with chronic indwelling catheters. Br J Urol. 1998;82(6):820–4.
Ackerman AL, Blaivas J, Anger JT. Female urethral reconstruction. Curr Bladder Dysfunct Rep. 2010;5(4):225–32.
Mukhtar BMB, Spilotros M, Malde S, Greenwell TJ. Ventral-onlay buccal mucosa graft substitution urethroplasty for urethral stricture in women. BJU Int. 2017;120(5):710–6.
Kuo H-C. Urodynamic parameters for the diagnosis of bladder outlet obstruction in women. Urol Int. 2004;72(1):46–51.
Defreitas GA, Zimmern PE, Lemack GE, Shariat SF. Refining diagnosis of anatomic female bladder outlet obstruction: comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology. 2004;64(4):675–9.
Rosenblum N, Nitti VW. Post-urethral suspension obstruction. Curr Opin Urol. 2001;11(4):411–6.
Kawashima A, Sandler CM, Wasserman NF, LeRoy AJ, King BF, Goldman SM. Imaging of urethral disease: a pictorial review. Radiographics. 2004;24(Suppl_1):S195–216.
Patel DN, Fok CS, Webster GD, Anger JT. Female urethral injuries associated with pelvic fracture: a systematic review of the literature. BJU Int. 2017;120(6):766–73.
Mazloomdoost D, Westermann LB, Mutema G, Crisp CC, Kleeman SD, Pauls RN. Histologic anatomy of the anterior vagina and urethra. Female Pelvic Med Reconstr Surg. 2017;23(5):329–35.
Keegan KA, Nanigian DK, Stone AR. Female urethral stricture disease. Curr Urol Rep. 2008;9(5):419–23.
Smith AL, Ferlise VJ, Rovner ES. Female urethral strictures: successful management with long-term clean intermittent catheterization after urethral dilatation. BJU Int. 2006;98(1):96–9.
Rosenblum N, Nitti VW. Female urethral reconstruction. Urol Clin North Am. 2011;38(1):55–64.
Hemal AK, Dorairajan LN, Gupta NP. Posttraumatic complete and partial loss of urethra with pelvic fracture in girls: an appraisal of management. J Urol. 2000;163(1):282–7.
Petrou SP, Rogers AE, Parker AS, Green KM, McRoberts JW. Dorsal vaginal graft urethroplasty for female urethral stricture disease. BJU Int. 2012;110(11) Pt C:E1090–5.
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.
Tao TT, Xu QK, Hu Q, Huang XJ, Chen J, Wang WZ, Lv BD, Duan Y. Novel surgical technique for female distal urethral stricture disease: an evaluation of efficacy and safety compared with urethral dilatation. Int J Clin Exp Med. 2018;11(11):12002–7.
Joshi PM, Kulkarni SB. A new technique of double-face buccal graft urethroplasty for female urethral strictures. Turk J Urol. 2019;46(2):165–8.
Önol FF, Önol ŞY, Tahra A, Boylu U. Ventral inlay labia minora graft urethroplasty for the management of female urethral strictures. Urology. 2014;83(2):460–4.
Hoag N, Gani J, Chee J. Vaginal-sparing ventral buccal mucosal graft urethroplasty for female urethral stricture: a novel modification of surgical technique. Investig Clin Urol. 2016;57(4):298–302.
Nayak P, Mandal S, Das M. Ventral-inlay buccal mucosal graft urethroplasty for female urethral stricture. Indian J Urol. 2019;35(4):273–7.
Singh RK, Kaushal D, Khattar N, Nayyar R, Manasa T, Sood R. Pediatric pelvic fracture urethral distraction defect causing complete urethrovaginal avulsion. Indian J Urol. 2018;34(1):76–8.
Bansal D, Nayyar R, Singh P, Jain S. Individualized management of obliterative urethral stricture in females – five patients five management strategies. Indian J Urol. 2019;35(Suppl 1):S8.
Nayyar R, Bansal D, Singh P, Jain S, Seth A. Individualized Management of Obliterative Urethral Stricture in Females – Four Patients Four Management Strategies. J Clin Urol. 2020; 13(4): 261–66.
Tanagho EA. Bladder neck reconstruction for total urinary incontinence: 10 years experience. J Urol. 1981;125(3):321–6.
Radwan MH, Abou Farha MO, Soliman MG, et al. Outcome of female urethral reconstruction: a 12-year experience. World J Urol. 2013;31:991–5.
Blaivas JG. Vaginal flap urethral reconstruction: an alternative to the bladder flap neourethra. J Urol. 1989;141:542–5.
Nayyar R, Jain S, Sharma K, Pethe S, Sharma P. A novel anterior bladder tube for traumatic bladder neck contracture in females: initial results. Urology. 2020;139:201–06.
Hampson LA, Myers JB, Vanni AJ, Virasoro R, Smith TG 3rd, Capiel L, Chandrapal J, Voelzke BB. Dorsal buccal graft urethroplasty in female urethral stricture disease: a multicenter experience. Transl Androl Urol. 2019 Mar;8(Suppl 1):S6–S12.
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Nayyar, R., Bansal, D., Nayyar, B.U. (2021). Female Urethral Stricture. In: Khattar, N., Nayyar, R., Panda, A. (eds) Female Bladder Outlet Obstruction and Urethral Reconstruction. Springer, Singapore. https://doi.org/10.1007/978-981-15-8521-0_8
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DOI: https://doi.org/10.1007/978-981-15-8521-0_8
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