Ventral-onlay buccal mucosa graft substitution urethroplasty for urethral stricture in women

Abstract

Objective: To present our outcomes of ventral-onlay buccal mucosa graft (BMG) substitution urethroplasty in treating female urethral stricture (FUS).

Patients and methods: We conducted a review of a prospectively collected database of 22 consecutive women (median [range] age 50 [34-72] years) with urethral stricture who underwent ventral onlay BMG substitution urethroplasty after June 2012 and who had a minimum follow-up of 6 months (median 21.5, range 6-51 months). Data were analysed for stricture recurrence, change in median maximum urinary flow rate (Q_max ) and median post-void residual urine volume (PVR). Statistical analysis was performed using the Wilcoxon signed rank test, Student's t-test and the Mann-Whitney U-test.

Results: Freedom from stricture recurrence was achieved in 21/22 (95.5%) women. The median (range) Q_max significantly improved, increasing from 7 (3.5-11) to 18 (5-37) mL/s (P <0.05). The median (range) PVR was significantly reduced from 100 (0-300) to 15 (0-150) mL (P < 0.05). Short- and longer-term complication rates were low. One woman developed mild de novo stress urinary incontinence, which settled with conservative management by 6 months.

Conclusions: Early and medium-term results indicate that ventral onlay BMG substitution urethroplasty is an excellent treatment for FUS that can avoid the need for the repeat procedures regularly required after traditional endoscopic management.

Keywords: buccal mucosa graft; female urethral stricture; urethroplasty; ventral.