Management of female urethral stricture disease (FUSD) with buccal
mucosal graft urethroplasty: outcomes and techniques
Abstract
Objective: Female urethral stricture (FUS) is an underreported
relatively rare condition, often resulting from a variety of causes.
They can result from any process that causes injury to urethral
epithelium which can then lead to scarring during the healing process of
the injury and subsequent formation of a stricture. We report our
experience with urethroplasty in women with urethral stricture with
dorsal onlay BMG Urethroplasty which is considered a promising technique
in view of anatomical and functional advantages. Design:
Retrospective study Setting: Single-centre study conducted at
Kanti Devi Medical College and Research Centre, Mathura, Uttar Pradesh,
India. Population or Sample: 30 female patients diagnosed with
urethral stricture who underwent dorsal onlay BMG urethroplasty between
February 2017 and February 2024. Methods: The study involved 30
female patients diagnosed with urethral stricture. Diagnostic methods
included patient symptoms, post-void residual urine measurements,
uroflowmetry, MCUG, and cystoscopy. The surgical techniques was dorsal
onlay BMG Urethroplasty. The indication was those female patients with
urethral stricture having failed urethral dilatation more than once. The
patients were followed postoperatively at 3, 6, and 12 months and
annually for up to five years. Key outcomes were improvement in LUTS,
Qmax, post-void residual (PVR) urine, and stricture recurrence.
Main Outcome Measures: Improvement in Qmax, PVR urine volume,
and stricture recurrence rate. Results: The mean age of the
patients was 50.77 ± 6.14 years. Preoperative uroflowmetry showed a mean
Qmax of 7.05 ± 1.81 mL/s, which improved significantly to 19.5 ± 2.83
mL/s postoperatively (p < 0.0001). Mean preoperative PVR was
116.07 ± 21.99 mL, which decreased to 29.13 ± 13.09 mL postoperatively
(p < 0.0001). The success rate of the procedure was 90%, with
a recurrence rate of 10%, managed with self-urethral dilation. No
patient developed de novo urinary incontinence. Conclusions:
Dorsal onlay BMG urethroplasty is a safe, effective, and technically
feasible treatment for FUSD, demonstrating a high success rate and
minimal risk of complications.