Female urethral stricture: a contemporary series.

Area of Science:

• Urology
• Female Pelvic Medicine

Background:

• Recurrent urethral stricture presents a significant challenge in female patients, often leading to refractory lower urinary tract symptoms (LUTS).
• Understanding the diverse etiologies and symptom profiles is crucial for effective management.

Purpose of the Study:

• To investigate the causes, symptoms, and treatment outcomes for female patients experiencing recurrent urethral strictures.
• To compare the efficacy of various surgical interventions for urethral stricture disease.

Main Methods:

• A prospective study involving 26 female patients diagnosed with urethral stricture and refractory LUTS.
• Treatments included urethroplasty with buccal mucosal graft (BMG) or vaginal flap, urethral dilatation, optical urethrotomy, and meatoplasty.
• Outcomes such as stricture cure, symptom improvement, and recurrent urinary tract infection (UTI) rates were prospectively recorded.

Main Results:

• Idiopathic strictures accounted for 42% of cases, with previous urethral instrumentation being another common cause (42%).
• Reduced flow (93%) was the most frequent symptom, followed by detrusor overactivity (50%) and UTIs (42%).
• Buccal mucosal graft (BMG) urethroplasty achieved a 93% cure rate, while vaginal flap urethroplasty had a 100% cure rate. Urethral dilatation failed to cure any patients.

Conclusions:

• Urethroplasty, in its various surgical forms, demonstrates superior cure rates for recurrent urethral strictures in women compared to other methods.
• The study highlights the effectiveness of reconstructive surgery, particularly BMG urethroplasty, in managing this condition.