Optimizing Outcome in Female Urethral Stricture Disease with Buccal Mucosal Graft Urethroplasty: Surgical Techniques and Considerations

Introduction: Female urethral stricture disease (FUSD) is a rare and often disregarded cause of blockage of the female bladder outlet. Diagnostic delays are typical because lower urinary tract symptoms (LUTS) might be confused with other, more prevalent urological disorders in women. Urethral dilatation (UD) has a significant risk of recurrence even though it is a first-line therapeutic. A dorsal onlay buccal mucosal graft (BMG) urethroplasty has emerged as a feasible alternative for surgical reconstruction due to its anatomical and functional advantages.Methods: This retrospective study was done at Kanti Devi Medical College and Research Centre, Mathura, Uttar Pradesh, India, from February ۲۰۱۷ to February ۲۰۲۴. ۳۰ female patients with urethral stricture underwent dorsal onlay BMG urethroplasty. Clinical symptoms, micturating cystourethrogram (MCUG), post-void residual (PVR) urine measures, uroflowmetry, and cystoscopy were used to make the diagnosis. Patients who had at least two unsuccessful attempts at urethral dilatation were eligible to participate. The same surgical team operated on each patient, performing dorsal onlay BMG urethroplasty. Evaluations of postoperative follow-up were carried out at ۳, ۶, and ۱۲ months, and subsequently once a year for a maximum of five years. Stricture recurrence, PVR urine volume decrease, and Qmax improvement were important endpoint indicators.Results: The mean age of this research population was ۵۰.۷۷±۶.۱۴ years. The mean Qmax was ۷.۰۵±۱.۸۱ mL/s according to preoperative uroflowmetry, but it significantly improved to ۱۹.۵±۲.۸۳ mL/s after surgery (P-value < ۰.۰۰۰۱). The average PVR urine volume before surgery was ۱۱۶.۰۷±۲۱.۹۹mL, and after surgery, it dropped to ۲۹.۱۳±۱۳.۰۹mL (P-value<۰.۰۰۰۱). Following female BMG urethroplasty, success was achieved in ۲۷ (۹۰%) cases, with recurrence observed in ۳ (۱۰%) cases. Self-urethral dilatation was used to successfully manage every recurrence case.Conclusions: A safe, efficient, and technically possible surgical option for treating female urethral stricture disease is dorsal onlay BMG urethroplasty. It offers minimal complications, a high success rate, and excellent functional outcomes. For women with recurrent or resilient urethral strictures, this method is a beneficial choice.

کلیدواژه ها:

Female Urethral Stricture Disease ، Buccal Mucosal Graft ، dorsal onlay urethroplasty ، female urethroplasty ، urethral reconstruction