Vol. 4, Issue 5 (2018)
Dorsal onlay vaginal mucosal graft urethroplasty for refractory female urethral stricture
Author(s): Dr. Devashish Kaushal, Dr. Saurabh Vashishtha, Dr. Amir Ali, Dr. Mandavi Agarwal
Abstract: Background: Female urethral stricture may account between 4-18% of all bladder outlet obstruction of females. Urethral dilatation is a simple easily available office procedure which improves urethral flow in most of them initially. Literature shows only 50-60% patients cured by urethral dilatation alone in long term follow up. We hereby presenting our study results of dorsal onlay vaginal mucosa graft urethroplasty in female urethral stricture disease, who are refractory to conservative urethral dilatation. Material & method: This is long term, hospital based, observational, follow up study. Patients were called for follow up from hospital data base, who have been operated by dorsal onlay female urethroplasty for female urethral stricture disease. Their preoperative urine flow, post void residual urine volume, urethral caliber, urinary incontinence, urgency, need of urethral dilatation Micturating Cystourethrogram records were compared with post-operative follow up records. Result: We identified eight women who underwent dorsal onlay vaginal graft urethroplasty in our institute from January 2013 to June 2017. The Mean age of our cohort was 50.62 years & mean follow up was 22.4 months. Mean postoperative urinary flow rate (Qmax) increased to 19.03 ml/s from preoperative urine flow 5.4 ml/S (P=0.0003). Similarly Post void residual urine reduced to mean 32.12 ml (Median =13 ml) from pre-operative mean 165.12 ml (Median = 137.5 ml) (P=0.049). Two patients required post urethroplasty urethral dilatation; post dilatation one patient was cured while another was subjected to redo urethroplasty with buccal mucosa graft. Conclusion: Dorsal onlay vaginal flap urethroplasty is a simple, feasible and effective surgical technique for female stricture urethra patients, refractory to repeated conservative urethral dilatations.