Technique and results of urethroplasty for female stricture disease. 2006

Catherine Elizabeth Bath Schwender, and Linda Ng, and Edward McGuire, and E Ann Gormley
Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.

OBJECTIVE Urethral stricture disease in females is uncommon and is often treated with repeat dilation or internal urethrotomies. Various surgical techniques to repair strictures have been described with successful results. However, these techniques are cumbersome to use. The vaginal inlay flap is simple and easy to learn. To our knowledge this is the first report of its use and clinical results in a series of patients from 2 institutions. METHODS Eight symptomatic women with a history of traumatic or difficult catheterization, a history of at least 1 urethral dilation or urethrotomy and difficult or a failed attempt at catheter placement underwent urethroplasty. The technique consisted of incising the posterior aspect of the stricture and advancing a vaginal inlay flap. A retrospective chart review was performed. RESULTS Followup was 1 to 9 years. All patients had subjective relief of symptoms and could easily catheterize with a 14Fr catheter. Average caliber of the urethra increased from 9.25Fr to 16.5Fr and post-void residual urine decreased from 130 to 15 cc. One patient with a hypotonic bladder was in retention, which resolved during 3 months. One patient underwent repeat dilation once 3 weeks after the primary procedure with no recurrence. No patient had stress urinary incontinence. There were no immediate or delayed serious complications. CONCLUSIONS Urethral stricture disease in females is an uncommon entity that can cause voiding symptoms, recurrent infections, retention and renal impairment. This method of surgical repair offers a durable result and has a low incidence of complications.

UI MeSH Term Description Entries
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013520 Urologic Surgical Procedures Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available. Procedure, Urologic Surgical,Procedures, Urologic Surgical,Surgical Procedure, Urologic,Surgical Procedures, Urologic,Urologic Surgical Procedure,Urological Surgical Procedures,Procedure, Urological Surgical,Procedures, Urological Surgical,Surgical Procedure, Urological,Surgical Procedures, Urological,Urological Surgical Procedure
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D014521 Urethra A tube that transports URINE from the URINARY BLADDER to the outside of the body in both the sexes. It also has a reproductive function in the male by providing a passage for SPERM. External Urethral Sphincter,External Urinary Sphincter,Internal Urethral Sphincter,Internal Urinary Sphincter,Internal Vesical Sphincter,Urethral Sphincters,External Urethral Sphincters,External Urinary Sphincters,Internal Urethral Sphincters,Internal Urinary Sphincters,Internal Vesical Sphincters,Sphincter, External Urethral,Sphincter, External Urinary,Sphincter, Internal Urethral,Sphincter, Internal Urinary,Sphincter, Internal Vesical,Sphincter, Urethral,Urethral Sphincter,Urethral Sphincter, External,Urethras,Urinary Sphincter, External,Urinary Sphincter, Internal,Vesical Sphincter, Internal
D014525 Urethral Stricture Narrowing of any part of the URETHRA. It is characterized by decreased urinary stream and often other obstructive voiding symptoms. Urethral Stenosis,Anterior Urethral Stricture,Posterior Urethral Stricture,Urethral Stricture, Anterior,Urethral Stricture, Posterior,Anterior Urethral Strictures,Posterior Urethral Strictures,Stenoses, Urethral,Stenosis, Urethral,Stricture, Urethral,Strictures, Urethral,Urethral Stenoses,Urethral Strictures,Urethral Strictures, Anterior,Urethral Strictures, Posterior

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