Treatment of Urethral Stricture Disease in Women: Nonsystematic Review of Surgical Techniques and Intraoperative Considerations

Abstract

Female urethral strictures are rare, but underdiagnosed pathologies that can cause voiding dysfunction. These strictures are best managed with open reconstruction, as endoscopic treatments have high rates of failure. A flap urethroplasty can be performed with vaginal, labial or bladder tissue. Meanwhile, graft urethroplasties can utilize vaginal, labial, buccal or lingual tissue. It is important to consider the etiology and type of stricture, local vascularity, and prior attempts at repair when selecting the type of repair. Multiple different techniques have been described with theoretical advantages to each one. While some studies have reviewed a few of the reconstructive techniques to treat female urethral strictures, no single study has accounted for each individual technique. In this review, we discuss techniques captured by a number of systematic reviews and other articles. We will herein focus on reviewing and describing each unique technique of reconstruction in the setting of female urethral stricture.

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

“…In a systematic review of FUS, etiology was defined in a total of 271 patients out of 554 as idiopathic in 139 (51.3%), iatrogenic in 89 (32.8%), inflammatory/infective in 25 (9.2%), and traumatic in 18 (6.6%) ( 13 ). Iatrogenic injuries include anterior vaginal or urinary tract surgery, urinary catheterization and radiotherapy of pelvic malignant tumors ( 14 ). Traumatic urethral injuries often result from obstetric complications.…”

Estenosis uretral femenina: una condición infradiagnosticada

“…También se han descrito colgajos tipo Martius para reducir la formación de fistulas, como también colgajos con el músculo gracilis o el músculo recto en caso de defectos grandes que requieran mayor área de cobertura. (26) En cuanto a pacientes con incontinencia o con alto riesgo de sufrir incontinencia posoperatoria se han descrito uretroplastias con procedimientos contra la incontinencia concomitantes exitosos.…”

“…• Imbibición capilar: el injerto se perfora con una aguja para ayudar a la imbibición capilar y a la inosculación del injerto. (26) Tabla 4. Técnicas de uretroplastia con injerto…”