Female urethral stricture: which one is stronger? Labial vs buccal graft

Şahin, Coşkun; Yeşildal, Cumhur

doi:10.1007/s00192-021-05052-x

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…In ureteral reconstruction, several studies have demonstrated that ureteroplasty using lingual mucosa grafts yields better recipient site outcomes and fewer donor site complications than that using BMG ( 37 , 38 ). In the study of FUS, only Coskun et al compared the effects of labial and buccal mucosa ( 39 ). There is a lack of more high-quality random controlled trails to further confirm the effects of different mucosa.…”

Section: Discussionmentioning

confidence: 99%

Dorsal oral mucosa graft urethroplasty for female urethral stricture reconstruction: A narrative review

Tao

Jin²,

Zhang³

2023

Front. Surg.

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Female urethral stricture is currently a challenging situation. In general, urethra dilatation can be selected for treatment, but the complications and high recurrence rate urge doctors to consider other treatments. Recently, dorsal oral mucosa graft urethroplasty is concerned by more and more surgeons, but there are not enough reports so far. A comprehensive search of dorsal oral mucosa graft urethroplasty was performed. According to the existing literature, there are applications of buccal mucosa and lingual mucosa, and compared with other kinds of grafts, the success rate is higher. However, there is a lack of multicenter, large sample and long follow-up studies. And there is still no enough comparative study between different types of oral mucosa. In summary, dorsal oral mucosa graft urethroplasty is an effective option for the management of female urethral stricture. More multicenter and large sample studies with long-term follow-up data are needed.

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Section: Discussionmentioning

confidence: 99%

Dorsal oral mucosa graft urethroplasty for female urethral stricture reconstruction: A narrative review

Tao

Jin²,

Zhang³

2023

Front. Surg.

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“…3 Patients may present with lower urinary tract symptoms, recurrent urinary tract infection, hesitancy, poor flow, frequency, urgency, urethral pain, high postvoid residual, or acute urinary retention. 4 A diagnosis is usually based on a complete urological and vaginal examination, 5 patient reported storage or voiding symptoms, 3,6 as well as a urine analysis and culture, if necessary. 5 An inability to pass even a small catheter due to stenosis in the distal urethra is suggestive of the diagnosis of stricture.…”

Section: Guideline Statementsmentioning

confidence: 99%

“…4 A diagnosis is usually based on a complete urological and vaginal examination, 5 patient reported storage or voiding symptoms, 3,6 as well as a urine analysis and culture, if necessary. 5 An inability to pass even a small catheter due to stenosis in the distal urethra is suggestive of the diagnosis of stricture. 6 3.…”

Section: Guideline Statementsmentioning

confidence: 99%

Urethral Stricture Disease Guideline Amendment (2023)

Wessells

Morey

Vanni³

et al. 2023

Journal of Urology

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Purpose:The symptoms of urethral stricture are non-specific and may overlap with other common conditions that can confound diagnosis. Urologists play a key role in the initial evaluation of urethral stricture, currently provide all accepted treatments, and must be familiar with the evaluation, diagnostic tests, and surgical treatments for urethral stricture.Materials and Methods:A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates January 1, 1990 to January 12, 2015) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of urethral stricture in men. The review yielded an evidence base of 250 articles after application of inclusion/exclusion criteria. The search for the 2023 Amendment was modified to included females and males (search dates December 2015—October 2022 for males; January 1990—October 2022 for females) and a new Key Question on sexual dysfunction was added (search dates: January 1990—10/2022). After inclusion and exclusion criteria were applied, 81 studies were added to the existing evidence base.Results:Once a urethral stricture is diagnosed, clinicians should determine the length and location of the stricture in order to inform treatment. After a period of urethral rest, patients with short (<2cm) bulbar urethral stricture may be treated endoscopically. Urethroplasty may be performed by an experienced surgeon in patients with first time or recurrent anterior and posterior urethral strictures. The best treatment option for urethral stricture in female patients is urethroplasty using oral mucosa grafts or vaginal flaps rather than endoscopic treatment.Conclusion:This guideline provides evidence-based guidance to clinicians and patients regarding how to recognize symptoms and signs of a urethral stricture/stenosis, carry out appropriate testing to determine the location and severity of the stricture, and recommend the best options for treatment. The most effective approach for a particular patient is best determined by the individual clinician and patient in the context of that patient's history, values, and goals for treatment.

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Surgery for female urethral stricture

Bouchard,

Campeau

2024

Neurourology and Urodynamics

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BackgroundFemale urethral stricture (FUS) is a rare entity that causes great morbidity and suffering in those affected. As the available scientific data is sparce, there are no formal guidelines or standard of care for this disease.MethodsThis is a narrative review of the surgical management for female urethral stricture. The literature review was performed on PubMed. Articles were limited to English, but there was no limitation in terms of date.ResultsManagement of FUS is divided between endoscopic and open surgical repair. Urethral dilation with or without urethrectomy can be offered as a first‐line treatment. However, the rate of success of this procedure remains inferior to open surgical repair, and its efficacy decreases with the number of previous dilations. For distal urethral strictures, distal urethrectomy and advancement meatoplasty may be considered. Vaginal flaps are readily available, easy to harvest, well‐vascularized, and allow for a dorsal or ventral orientation urethroplasty. The results of this procedure are promising, but most studies are small and retrospective. Labia flaps are easily accessible, wet, hairless, and elastic. The main limitations with the use of vaginal or labial tissues are co‐existing conditions such as lichen sclerosis or vaginal atrophy, which may affect future results. Vaginal and labial graft urethroplasty can be used when it is not possible to mobilize an adequate flap. Stricture‐free rates of this technique are variable. In cases of more severe stricture, an augmentation urethroplasty using buccal mucosa graft may be necessary. The techniques used in FUS replicate those for male urethral strictures, where both ventral and dorsal approaches can be utilized.ConclusionsAlthough there is growing interest in the field, the optimal management of FUS remains to be determined.

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Female urethral stricture: which one is stronger? Labial vs buccal graft

Cited by 4 publications

References 31 publications

Dorsal oral mucosa graft urethroplasty for female urethral stricture reconstruction: A narrative review

Dorsal oral mucosa graft urethroplasty for female urethral stricture reconstruction: A narrative review

Urethral Stricture Disease Guideline Amendment (2023)

Surgery for female urethral stricture

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