Long-term management of luminal urethral stricture in women

Popat, Shreeya; Zimmern, Philippe E.

doi:10.1007/s00192-016-3006-8

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…Although a working definition of FUS is available, 2 absolute values of quantitative parameters are still undecided. Owing to a lack of consensus on the urethral calibration, authors used a range from <10 F, 17 <12 F, 21 <13 F, 24,34 <14 F, 8,10–13,18,30 <17 F, 14,20,27,29 <18 F 23 to <19 F 5,15,33 …”

Section: Resultsmentioning

confidence: 99%

Deciphering the enigma of female urethral strictures: A systematic review and meta‐analysis of management modalities

Sarin

Narain

Panwar

et al. 2020

Neurourology and Urodynamics

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Objective: To evaluate the management methods of female urethral stricture (FUS) and analyze the outcomes of surgical treatments. A meta-analysis was done in an attempt to identify the best approach of urethroplasty and the graft-of-choice. Materials and Methods: A systematic search of Pubmed/Medline and Embase databases was performed according to the Preferred Reporting Items For Systematic Review And Meta-Analysis statement, for articles reporting on FUS management in the last decade. The Newcastle-Ottawa scale was used to assess the quality of 28 included non-randomized studies. The data on FUS management was summarized and pooled success rates (taken as symptom improvement and no need for further instrumentation) were compared. The secondary outcome was to establish a diagnostic modality of choice and define a "successful-outcome" of repair. Results: The outcome was separately reported for 554 women undergoing surgical intervention for FUS in the literature. The criteria defining FUS were varied. A combination of tests was used for diagnosis as none was singularly conclusive. A total of 301 patients had previous urethral instrumentations. The pooled success rate of urethral dilatation (234 women) was 49% at a mean follow-up of 32 months; flap urethroplasty (108 cases) was 92% at a mean followup of 42 months; buccal mucosal graft (BMG) urethroplasty (133 cases) was 89% at a mean follow-up of 19 months; vaginal graft augmentation (44 cases) was 87% at a mean follow-up of 15 months; and labial graft reconstruction (19 cases) was 89% at a mean follow-up of 18.4 months. The dorsal approach of graft augmentation met with 88% (95% confidence interval [CI] 0.79-0.95) success compared with 95% (95% CI 0.86-1) for the ventral approach. Conclusion: FUS is a rare condition requiring a meticulous diagnostic workup using multiple tests. All urethroplasties have shown better pooled success rates (86%-93%) compared with dilatation (49%). BMG is equally effective as vaginal graft urethroplasty.

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Section: Resultsmentioning

confidence: 99%

Deciphering the enigma of female urethral strictures: A systematic review and meta‐analysis of management modalities

Sarin

Narain

Panwar

et al. 2020

Neurourology and Urodynamics

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“…While the surgical management of female USD is still evolving,[1826] we are the first to describe, to the best of our knowledge, a case series with the ventral-inlay technique. We found the technique to be simple, successful, and with many perceived advantages.…”

Section: Discussionmentioning

confidence: 99%

Ventral-inlay buccal mucosal graft urethroplasty for female urethral stricture

2019

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Introduction:The aim of the study is to present our initial experience with ventral-inlay buccal mucosal graft urethroplasty (VI-BMGU) in female urethral stricture disease (USD).Methods:Between May 2016 and June 2018, 12 women with USD underwent VI-BMGU. All women were evaluated preoperatively with the American Urological Association (AUA) symptom score, uroflowmetry, calibration with a 12 Fr catheter, and ultrasonography with postvoid residual (PVR) urine measurement. Intraoperative confirmation of stricture was done with a 6 Fr cystoscope. Postoperatively, the women were followed at 3, 6, and 12 months after surgery with AUA symptom score, uroflowmetry, and PVR estimation. Increase in AUA symptom score, maximum flow rate (Qmax) <12 ml/s, and failure to calibrate with 18 Fr catheters were considered as indicative of recurrence of the disease.Results:The mean age of the patients was 41 years. The mean follow-up period was 18 months. All women voided successfully after catheter removal. There was an improvement in AUA symptom score and Qmax and a reduction in PVR at 3, 6, and 12 months. One woman had recurrence of stricture at 6 months and was treated by urethral dilatation followed by the institution of a self-dilatation regimen. The success rate was 92% in our case series.Conclusions:VI-BMGU is a simple and safe method of urethroplasty in women. Studies with a larger sample size and a longer follow-up are required to document the long-term success of this procedure.

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“…A contemporary series examining urethral dilation under general anaesthesia for FUS in 30 women demonstrated a success rate (defined as no secondary procedure or need for long-term CIC) of 43% (16). In those who failed the initial procedure, minimal benefit was noted with subsequent urethral dilation (16).…”

Section: Surgical Managementmentioning

confidence: 99%

“…In those who failed the initial procedure, minimal benefit was noted with subsequent urethral dilation (16). …”

Section: Surgical Managementmentioning

confidence: 99%

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Surgical management of female urethral strictures

Hoag¹,

Chee²

2017

Transl. Androl. Urol.

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Female urethral stricture (FUS) represents a rare condition, yet one that can cause significant, bothersome lower urinary tract symptoms (LUTS). Historically, urethral dilation has been a preferred treatment choice for these patients. A variety of reconstructive surgical techniques have been described in recent years to provide more definitive management in this challenging group of patients. We present an overview of FUS and a summary of surgical management options.

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Long-term management of luminal urethral stricture in women

Abstract: At a mean follow-up of 5 years, UD for LUS produced durable resolution in 43 % of our patients. Another 30 % fully benefited from repeat UDs. Shorter duration of symptoms before presentation was significantly associated with success.

Cited by 21 publications

References 20 publications

Deciphering the enigma of female urethral strictures: A systematic review and meta‐analysis of management modalities

Deciphering the enigma of female urethral strictures: A systematic review and meta‐analysis of management modalities

Ventral-inlay buccal mucosal graft urethroplasty for female urethral stricture

Surgical management of female urethral strictures

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