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      Dorsal buccal graft urethroplasty in female urethral stricture disease: a multi-center experience

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          Abstract

          Background

          Female urethral stricture disease is under-recognized and is often treated with dilation despite poor definitive outcomes. Our objective was to describe a multi-institutional experience treating female urethral stricture disease with female dorsal onlay buccal mucosa graft (FD-BMG) urethroplasty outcomes.

          Methods

          We retrospectively identified 39 consecutive FD-BMG urethroplasty operations performed by 6 reconstructive surgeons from 12/2007 to 1/2016. Surgical technique included dorsally-placed buccal mucosal grafts in all cases. Stricture recurrence was defined by cystoscopy.

          Results

          Mean age was 50 (range, 29–81) years. Stricture etiology was unknown (49%), iatrogenic (36%), or trauma/straddle injury (15%). A majority of women (87%) women had undergone a prior stricture-related urethral procedure(s) before the surgeons’ index urethroplasty. Mean stricture length was 2.1 cm and mean caliber was 11 Fr. Mean postoperative follow-up was 33 (range, 7–106) months. Postoperative complications within 30 days were seen in 7 individuals (18%) and were all Clavien-Dindo grade II. Stricture recurrence was seen in 9 (23%) patients, with mean time to recurrence 14 months. No patients experienced de novo incontinence.

          Conclusions

          FD-BMG urethroplasty is a safe and effective management option for female urethral strictures. Referral to a reconstructive center is encouraged to avoid repeated unnecessary endoscopic procedures that have poor definitive success.

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          Author and article information

          Journal
          Transl Androl Urol
          Transl Androl Urol
          TAU
          Translational Andrology and Urology
          AME Publishing Company
          2223-4691
          March 2019
          March 2019
          : 8
          : Suppl 1
          : S6-S12
          Affiliations
          [1 ]Department of Urology, University of Washington School of Medicine , Seattle, WA, USA;
          [2 ]Department of Urology, University of California San Francisco Medical Center , San Francisco, CA, USA;
          [3 ]Division of Urology, University of Utah Health , Salt Lake City, UT, USA;
          [4 ]Center for Reconstructive & Urologic Surgery, Lahey Hospital & Medical Center , Burlington, MA, USA;
          [5 ]Department of Urology, Eastern Virginia Medical School , Norfolk, VA, USA;
          [6 ]Department of Urology, Baylor College of Medicine , Houston, TX, USA;
          [7 ] Centro de Educación Medica e Investigaciones Clínicas (CEMIC) , Buenos Aires, Argentina;
          [8 ] University of Utah Health , Salt Lake City, UT, USA
          Author notes

          Contributions: (I) Conception and design: LA Hampson, BB Voelzke; (II) Administrative support: None; (III) Provision of study materials or patients: JB Myers, TG Smith 3rd, AJ Vanni, R Virasoro, BB Voelzke, L Capiel; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: LA Hampson, JB Myers, TG Smith 3rd, AJ Vanni, R Virasoro, BB Voelzke; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

          Correspondence to: Dr. Bryan B. Voelzke, MD, MS, FACS. Spokane Urology, 1401 East Trent Ave, Spokane, WA 99292, USA. Email: voelzkeb@ 123456SpokaneUrology.com .
          Article
          PMC6511700 PMC6511700 6511700 tau-08-S1-S6
          10.21037/tau.2019.03.02
          6511700
          31143666
          2b9fe796-ec73-418b-a9a1-eb7644eb76c2
          2019 Translational Andrology and Urology. All rights reserved.
          History
          : 07 December 2018
          : 27 February 2019
          Categories
          Original Article

          urethra,reconstruction,Stricture,female
          urethra, reconstruction, Stricture, female

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