Female Urethroplasty: A Critical Review of Indications, Techniques and Concerns

Bladder outlet obstruction (BOO) is uncommon in women, accounting for only 2.7-8% of those referred for voiding issues. Female urethral stricture (FUS) is an infrequent type of female BOO, making up just 4-13% of cases (Colleselli et al. J Urol 160:49-54, 1998). Although urethral dilation (UD) has traditionally been the main treatment, it is often considered overused and unnecessary, leading to significant healthcare costs (Yucel et al. J Urol 171:1890-7, 2004). Recently, interest has increased in female urethroplasty, with various methods being employed to establish a permanent solution. The rarity of the condition, limited clinical experience, and concerns about functional risks such as urinary incontinence may discourage urologists from performing female urethroplasty. This review offers a practical guide for urologists managing female urethral strictures, including an overview of the female urethral sphincter mechanism and the most common urethroplasty techniques. Institutional ethics board approval is not required for this review article; however, proper consent for using operative images involving human participants has been obtained from the respective patients before surgery.