Outcome of dorsal buccal graft urethroplasty in female urethral stricture disease (FUSD); our institutional experience

Khawaja, Abdul Rouf; Dar, Yaser Ahmad; Bashir, Farzana; Wani, Prince Muzafer; Bhat, Aashiq Hussain; Wani, Mohammad Saleem

doi:10.1007/s00192-021-04840-9

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…Free grafts may be obtained from local tissue (vaginal, labial) and oral mucosa (buccal, lingual). Tables 3 and 4 compile the past 10-year-period study outcomes of local and oral grafts, respectively [2,23,25,26,30,[33][34][35][36][37][38][39][40][41][42][43][44] . Vaginal or labial graft augmentation had an 80%-87% mean success rate, whereas oral mucosa grafts' mean success rate ranged between 89%-94% [4,20] .…”

Section: Graftsmentioning

confidence: 99%

“…The decision to place a ventral graft relies on the presumption that it is an easier dissection and that it would preserve sexual function, although there is one study that showed that sexual function is not affected with dorsal approach and, even more, it documented an improvement in sexual function scores [38] . In their respective series, none of the authors performing a dorsal approach reported a decrease in sexual function [39][40][41] . A dorsal approach preserves ventral tissue planes in case there is a need for a future continence procedure.…”

Section: Graftsmentioning

confidence: 99%

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Female urethral stricture: techniques for reconstruction

Toledo¹,

DeLong²

2022

PAR

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Female urethral stricture (FUS) is a rare condition. It was not studied robustly for many years, but interest has grown recently in the reconstructive urology community, leading to an increase in publications. In this review, we gather the latest data regarding FUS and its different therapeutic options. Studies are summarized, split by technique. We also review the recently published European Guidelines. In addition, we share our preferred surgical technique and our views on future options. Diagnosing FUS can often be challenging and requires a high index of clinical suspicion. Its vague clinical symptoms and empiric initial treatments combine to make FUS an underdiagnosed condition. The lack of consensus on how to define FUS also compounds the problem. Appropriate diagnosis requires thorough investigation, and ancillary studies such as video urodynamics, cystoscopy, and voiding cystourethrogram may be useful. Treatment options range from conservative management to definitive procedures, although studies have shown that conservative measures such as urethral dilation have a low success rate overall. Within definitive management, augmented urethroplasty - using either flaps or grafts, has proven to be the gold standard. Both have shown excellent results over time; however, there is insufficient data available to recommend one over the other. Contemporary data has an overall poor level of evidence. Although challenging due to the rarity of the problem, a proper randomized controlled clinical trial comparing the principal surgical options and their outcomes would be beneficial and would allow for more informed decision making when considering options for women with urethral stricture.

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Section: Graftsmentioning

confidence: 99%

Section: Graftsmentioning

confidence: 99%

Female urethral stricture: techniques for reconstruction

Toledo¹,

DeLong²

2022

PAR

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“…Eight studies were included: six prospective non comparative studies, one large retrospective comparative study and one small RCT [32,[35][36][37][40][41][42][43]. The techniques used were very heterogeneous in terms of approach (dorsal vs ventral) and tissue used (local flap vs free graft).…”

Section: Urethroplastymentioning

confidence: 99%

“…The techniques used were very heterogeneous in terms of approach (dorsal vs ventral) and tissue used (local flap vs free graft). The cure or reduction of obstruction rates were 77% and 88% in the two studies reporting it within the first year [32,40] and 85.7% to 95.5% in the three studies reporting it after a follow-up of 1 to 5 years [35,37,43] certainty of evidence: very low. Four studies reported the change in Qmax, PVR and IPSS within the first year with significant improvement of all these parameters compared to baseline certainty of evidence: very low [32,36,40,42].…”

Section: Urethroplastymentioning

confidence: 99%

Benefits and harms of conservative, pharmacological, and surgical management options for women with bladder outlet obstruction: A systematic review from the European Association of Urology non-neurogenic female LUTS guidelines panel

Peyronnet¹,

Omar²,

O’Connor³

et al. 2021

European Urology

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“…In most of the cases the stricture is usually located distally to the external ureatheral sphincter. The measurement of residual volume and uroflometry are normally used for the local examinations [5][6] .…”

Section: Introductionmentioning

confidence: 99%

Dorsal Onlay Urethroplasty Using Buccal Mucosal Graft and Vaginal Wall Graft for Female Urethral Stricture; Outcome of a Tertiary Care Hospital

Hassan¹,

Siraj²,

Khan³

et al. 2022

PJMHS

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Background: Normally female urethral stricture (FUS) is uncommon and underdiagnosed condition. It is raising a diagnostic challenge for the physicians. It is the one of the rarely known urological entity. Urethral dilatation is the traditionally used treatment for urethral stricture (FUS). The female urethroplasty have shown the promising outcomes. Objective: The objective of the study was to compare the outcome of the dorsal onlay urethoplasty FU obtained by using buccal mucosal graft and vaginal wall graft. The FU is more effective treatment for female urethral stricture (FUS) as compared to the repeated dilatation. Study design: It is a retrospective study with the statistical approach, conducted at Urology Department, Pakistan Institute of Medical Sciences Islamabad from June 2021 to November 2021. Material and Methods: The women who underwent the dorsal onlay urethropasty at the urology department of the hospital were included in the study. The outcomes of BMG and VWG were compared. The re-intervention was marked as failure. The association symptom score, postvoid residual urine (PVR), cystourethrogram, cystoscopy and uretheral calibration were included in the assessment. Operating time, catheter time, etiology, location, length, prior interventions and suprapubic cystostomy were the other parameters that was also reported. For the statistical analysis the Mann-Whitney test, t-test and proportion test was performed. Results: The calculated mean age of the patients included in the group was 48 years. Its range was between the 26 to 76 years. The women visited the urology department of the hospital from June 2021 to June 2022. The average follow-up was for 26 months. The AUA symptoms changes from 22 to 6, Qmax from 4ml/s to 26ml/s and RVR from 185ml to 7ml. The operating time was the only parameter showed the difference, while other remained the same. The 94% was the overall urethral patency rate. Conclusion: For the substitution of dorsal onlay urethroplasty the use of VWG and BMG is highly recommended. It is an efficient and reliable treatment method. There are very low chances of complication and it has an easy protocol. Apparently, no specific change was observed in the FUS treatment by BMG and VWG. Keywords: Female urethral stricture (FUS), buccal mucosal graft, vaginal wall graft, postvoid residual urine (PVR), dorsal onlay urethroplasty.

show abstract

Outcome of dorsal buccal graft urethroplasty in female urethral stricture disease (FUSD); our institutional experience

Cited by 7 publications

References 18 publications

Female urethral stricture: techniques for reconstruction

Female urethral stricture: techniques for reconstruction

Benefits and harms of conservative, pharmacological, and surgical management options for women with bladder outlet obstruction: A systematic review from the European Association of Urology non-neurogenic female LUTS guidelines panel

Dorsal Onlay Urethroplasty Using Buccal Mucosal Graft and Vaginal Wall Graft for Female Urethral Stricture; Outcome of a Tertiary Care Hospital

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