Outcome of female urethral reconstruction: a 12-year experience

To report our experience over 12 years in female urethral reconstruction with either anterior bladder tube (Tanagho) or labia minora pedicled tube.

This retrospective study included 16 patients with posttraumatic urethral loss. The patients were divided into two groups. Group I: included 6 patients managed with combined vaginal and abdominal approach using a proximally based anterior bladder tube (Tanagho) and Group II: included 10 patients underwent repair with labial fat pad flap with concomitant TOT sling. Outcomes included the success or failure of anatomical repair and continence, which was assessed during patient follow up by voiding diary, 24-h pad test and uroflowmetry.

A total of 15 patients were followed for a mean of 42 months postoperatively, and only one patient was lost to follow up. Total continence was achieved in 10 patients (66.6 %) [4/6 patients (66.6 %) in group I and 6/9 patients (66.6 %) in group II]. Partial continence (i.e., one or two pad per day) was achieved in 2 patients (13.3 %). Failure occurs in 3 cases (20 %) [one case in group I and two cases in group II]. All our patients had a smooth postoperative course. In the labia pedicled tube, meatal stenosis was encountered in one patient and transient postoperative urine retention in 2 patients. Successful anatomical repair was achieved in all our patients.

Both Bladder tube and labia minora pedicled tube with sling procedure have high success rate with only minor complications and are equally effective in the management of females with total urethral loss. Due to the small number of patients in this study, we still need to extend our study to verify our results.