Contemporary surgical management of female urethral stricture disease

Female urethral stricture disease is increasingly recognized as an uncommon but important cause of lower urinary tract symptoms in women, which is amenable to surgical treatment. Several new reconstructive techniques have recently been described. The purpose of this review is to summarize the past literature with a focus on more recent contributions.

Several new studies have recently been published investigating previously described reconstructive techniques including vaginal flap urethroplasty using the ventral approach, ventral labial graft, dorsal vaginal graft and dorsal buccal mucosal graft urethroplasty. Success rates, variably defined, ranged from 57.1 to 100% in these new contributions. No incidences of stress urinary incontinence were described. There continues to be lack of robust evidence to advocate one technique of urethroplasty for female urethral stricture disease over another, surgeon experience is likely to be an important factor.

Urethroplasty using a flap or graft augmentation is a feasible treatment for female urethral strictures with good reported success rates and a minimal risk of stress of incontinence. Further studies are required to define the optimal technique and approach.