Update on female urethral reconstruction.

Area of Science:

• Urology
• Gynecology

Background:

• Female urethral stricture (FUS) is an underdiagnosed condition causing significant morbidity.
• It affects approximately 1% of women presenting with lower urinary tract symptoms.

Purpose of the Study:

• To provide an updated review of current evidence on the management of female urethral stricture.
• To highlight diagnostic approaches and treatment efficacies for FUS.

Main Methods:

• Review of current literature on female urethral stricture.
• Analysis of diagnostic tools including pelvic examination, uroflowmetry, endoscopy, urethrography, and urodynamics.
• Evaluation of treatment outcomes for urethral dilation and reconstructive surgery.

Main Results:

• Idiopathic causes account for 50% of FUS cases, with iatrogenic factors, infection, inflammation, and trauma contributing to the remainder.
• Symptoms are often nonspecific, necessitating a high index of suspicion for diagnosis.
• Urethral dilation shows high recurrence rates (>50%), whereas reconstructive surgery achieves approximately 90% curative rates.

Conclusions:

• Early identification of FUS is crucial.
• Urethral dilation is a viable first-line treatment, but reconstructive surgery should be considered after one or two failed attempts at referral centers for better outcomes.