Female urethroplasty: contemporary thinking View Full Text


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Article Info

DATE

2018-11-19

AUTHORS

C. West, A. Lawrence

ABSTRACT

PURPOSE: Female urethral stricture disease is a rare entity. To date, its diagnosis and treatment have been poorly studied, with small numbers, and variable definitions of success. With growing interest in this area of reconstructive urology, there is an increased number of surgical techniques. In this article, we review current trends, definitions, etiologies and surgical techniques available for management of FUSD. METHOD: We completed a review of publications in: English; Pubmed, and Google scholar. Key words identified for review were, female urethra stricture, female urethroplasty and female urethral dilation, female pelvic fracture, and female urethral reconstruction. Papers were reviewed, and references of relevant papers reviewed. RESULTS: Iatrogenic injury is the most common cause of female urethral stricture disease. Assessment requires a thorough patient history, examination and either flexible cystoscopy and/or fluoroscopic urodynamics to determine the most appropriate surgical approach for stricture repair. Multiple open urethroplasty techniques are described with various grafts and flaps, with good medium-term success. Minimally invasive techniques remain well-employed but have poor long-term success, with increased failure with multiple attempts at treatment. CONCLUSION: Female urethral stricture disease is a complex clinical entity that requires a measured and thorough evaluation. Individualized approach should be undertaken reviewing the patient's symptoms, the stricture's etiology, surrounding vaginal tissue health and stricture location. Promising medium-term success rates with vaginal flaps and buccal mucosal graft urethroplasty have been reported, with disappointing long-term results from repeated urethral dilation. Further research comparing techniques and defining successful long-term outcomes is required. More... »

PAGES

1-11

References to SciGraph publications

  • 2017-08. Two cases of female urethral reconstruction with acellular porcine urinary bladder matrix in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2016-11. Long-term management of luminal urethral stricture in women in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2008. Female Urethral Reconstruction in URETHRAL RECONSTRUCTIVE SURGERY
  • 2013-08. Outcome of female urethral reconstruction: a 12-year experience in WORLD JOURNAL OF UROLOGY
  • 2014-04. Dorsal onlay buccal mucosal graft urethroplasty in female urethral stricture disease: a single-center experience in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2017-06. Female urethral stricture: a contemporary series in WORLD JOURNAL OF UROLOGY
  • 2010-12. Female Urethral Reconstruction in CURRENT BLADDER DYSFUNCTION REPORTS
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00345-018-2564-4

    DOI

    http://dx.doi.org/10.1007/s00345-018-2564-4

    DIMENSIONS

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    PUBMED

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    50 schema:description PURPOSE: Female urethral stricture disease is a rare entity. To date, its diagnosis and treatment have been poorly studied, with small numbers, and variable definitions of success. With growing interest in this area of reconstructive urology, there is an increased number of surgical techniques. In this article, we review current trends, definitions, etiologies and surgical techniques available for management of FUSD. METHOD: We completed a review of publications in: English; Pubmed, and Google scholar. Key words identified for review were, female urethra stricture, female urethroplasty and female urethral dilation, female pelvic fracture, and female urethral reconstruction. Papers were reviewed, and references of relevant papers reviewed. RESULTS: Iatrogenic injury is the most common cause of female urethral stricture disease. Assessment requires a thorough patient history, examination and either flexible cystoscopy and/or fluoroscopic urodynamics to determine the most appropriate surgical approach for stricture repair. Multiple open urethroplasty techniques are described with various grafts and flaps, with good medium-term success. Minimally invasive techniques remain well-employed but have poor long-term success, with increased failure with multiple attempts at treatment. CONCLUSION: Female urethral stricture disease is a complex clinical entity that requires a measured and thorough evaluation. Individualized approach should be undertaken reviewing the patient's symptoms, the stricture's etiology, surrounding vaginal tissue health and stricture location. Promising medium-term success rates with vaginal flaps and buccal mucosal graft urethroplasty have been reported, with disappointing long-term results from repeated urethral dilation. Further research comparing techniques and defining successful long-term outcomes is required.
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