Lindsay A Hampson1,2, Jeremy B Myers3, Alex J Vanni4, Ramón Virasoro5, Thomas G Smith6, Leandro Capiel7, Jason Chandrapal8, Bryan B Voelzke1. 1. Department of Urology, University of Washington School of Medicine, Seattle, WA, USA. 2. Department of Urology, University of California San Francisco Medical Center, San Francisco, CA, USA. 3. Division of Urology, University of Utah Health, Salt Lake City, UT, USA. 4. Center for Reconstructive & Urologic Surgery, Lahey Hospital & Medical Center, Burlington, MA, USA. 5. Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. 6. Department of Urology, Baylor College of Medicine, Houston, TX, USA. 7. Centro de Educación Medica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina. 8. University of Utah Health, Salt Lake City, UT, USA.
Abstract
BACKGROUND: Female urethral stricture disease is under-recognized and is often treated with dilation despite poor definitive outcomes. Our objective was to describe a multi-institutional experience treating female urethral stricture disease with female dorsal onlay buccal mucosa graft (FD-BMG) urethroplasty outcomes. METHODS: We retrospectively identified 39 consecutive FD-BMG urethroplasty operations performed by 6 reconstructive surgeons from 12/2007 to 1/2016. Surgical technique included dorsally-placed buccal mucosal grafts in all cases. Stricture recurrence was defined by cystoscopy. RESULTS: Mean age was 50 (range, 29-81) years. Stricture etiology was unknown (49%), iatrogenic (36%), or trauma/straddle injury (15%). A majority of women (87%) women had undergone a prior stricture-related urethral procedure(s) before the surgeons' index urethroplasty. Mean stricture length was 2.1 cm and mean caliber was 11 Fr. Mean postoperative follow-up was 33 (range, 7-106) months. Postoperative complications within 30 days were seen in 7 individuals (18%) and were all Clavien-Dindo grade II. Stricture recurrence was seen in 9 (23%) patients, with mean time to recurrence 14 months. No patients experienced de novo incontinence. CONCLUSIONS: FD-BMG urethroplasty is a safe and effective management option for female urethral strictures. Referral to a reconstructive center is encouraged to avoid repeated unnecessary endoscopic procedures that have poor definitive success.
BACKGROUND: Female urethral stricture disease is under-recognized and is often treated with dilation despite poor definitive outcomes. Our objective was to describe a multi-institutional experience treating female urethral stricture disease with female dorsal onlay buccal mucosa graft (FD-BMG) urethroplasty outcomes. METHODS: We retrospectively identified 39 consecutive FD-BMG urethroplasty operations performed by 6 reconstructive surgeons from 12/2007 to 1/2016. Surgical technique included dorsally-placed buccal mucosal grafts in all cases. Stricture recurrence was defined by cystoscopy. RESULTS: Mean age was 50 (range, 29-81) years. Stricture etiology was unknown (49%), iatrogenic (36%), or trauma/straddle injury (15%). A majority of women (87%) women had undergone a prior stricture-related urethral procedure(s) before the surgeons' index urethroplasty. Mean stricture length was 2.1 cm and mean caliber was 11 Fr. Mean postoperative follow-up was 33 (range, 7-106) months. Postoperative complications within 30 days were seen in 7 individuals (18%) and were all Clavien-Dindo grade II. Stricture recurrence was seen in 9 (23%) patients, with mean time to recurrence 14 months. No patients experienced de novo incontinence. CONCLUSIONS: FD-BMG urethroplasty is a safe and effective management option for female urethral strictures. Referral to a reconstructive center is encouraged to avoid repeated unnecessary endoscopic procedures that have poor definitive success.
Authors: Peter Rehder; Bernhard Glodny; Renate Pichler; Lukas Exeli; Andrea Kerschbaumer; Michael Josef Mitterberger Journal: BJU Int Date: 2010-10 Impact factor: 5.588
Authors: Ronald J Kim; James M Kerns; Shirley Liu; Ted Nagel; Paul Zaszczurynski; Dan Li Lin; Margot S Damaser Journal: Anat Rec (Hoboken) Date: 2007-02 Impact factor: 2.064
Authors: Kevin J Chua; Mark Mikhail; Hiren V Patel; Alexandra L Tabakin; Sai Krishnaraya Doppalapudi; Joshua Sterling; Hari Sgr Tunuguntla Journal: Res Rep Urol Date: 2021-06-21