Vestibular flap urethroplasty in women with recurrent distal intramural urethral pathology

Romman, Adam; Takacs, Liz; Gilleran, Jason

doi:10.1002/nau.22552

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Half of all patients (276), underwent previous interventions in the form of UDs/urethrotomies (98.2%) or urethroplasty (1.8%). 5,6,8,[10][11][12][13][14]16,17,[20][21][22]27,33,34 3.2 | Treatment of urethral stricture disease…”

Section: Definitions Diagnostic Modalities and Etiologymentioning

confidence: 99%

“…In the last decade, 10 studies described the techniques of flap urethroplasty on 108 patients (Table 2B). 5,8,[12][13][14]20,22,27,30,32 Of these, 96 patients (89%) had a previous history of urethral dilatation/urethrotomy and one had a flap urethroplasty. underwent a pubovaginal sling placement, four had a Martius flap; diverticulectomy and nephrectomy were done in one each.…”

Section: Flap Urethroplastymentioning

confidence: 99%

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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: Definitions Diagnostic Modalities and Etiologymentioning

confidence: 99%

Section: Flap Urethroplastymentioning

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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“…Romman et al described a lateral vestibular flap. 44 This new technique was created to prevent the shorter hypospadic urethra associated with a ventral flap while avoiding injury at the 12 o’clock position which theoretically can lead to effects on sexual function. This repair also employs a broad based vascular flap to improve distal viability.…”

Section: Treatment Of Female Urethral Stricturementioning

confidence: 99%

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

Chua¹,

Mikhail²,

Patel³

et al. 2021

RRU

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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.

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Reconstruction of the Absent or Severely Damaged Urethra

Sebesta

Reynolds²,

Dmochowski³

2023

Female Genitourinary and Pelvic Floor Reconstruction

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Vestibular flap urethroplasty in women with recurrent distal intramural urethral pathology

Abstract: Vestibular flap urethroplasty is a viable long-term treatment option in women with DIU who have failed at least one dilation.

Cited by 4 publications

References 24 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

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

Reconstruction of the Absent or Severely Damaged Urethra

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