Dorsal Onlay Labial Mucosal Graft Urethroplasty in Female Urethral Stricture: Outcomes of Over 200 Cases from a Single Surgeon.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-05-23 DOI:10.1016/j.urology.2025.05.040

Ajit Kumar Jena, Rahul Jena, Manupirya Madhavan, Kumar Madhavan

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引用次数: 0

Abstract

Ovjectives: To evaluate the outcomes of dorsal onlay labial mucosal graft urethroplasty in female urethral stricture (FUS), a condition that remains challenging and frequently underdiagnosed due to nonspecific symptoms and diagnostic limitations.

Methods: A retrospective analysis of a prospectively maintained database was conducted, including 204 patients who underwent dorsal onlay labial mucosal graft urethroplasty for FUS between June 2013 and July 2024. Patients were included if they had symptomatic FUS confirmed by uroflowmetry, micturating cystourethrogram (MCU), or urethral calibration. Outcomes assessed included clinical success rates, recurrence, complications, and subjective improvement based on the Global Impression of Improvement (GII).

Results: The mean operative time was 97.7 ± 13 minutes, with a median hospital stay of 2 days (range: 2-11). Perioperative complications were minimal, with six cases (2.94%) of Clavien-Dindo grade 2-3 complications and no significant donor-site morbidity. At a median follow-up of 29 months (range: 7-231), clinical success rates were 98.5%, 97.5%, and 93.5% at 1-3 months, 6 months, and 2 years, respectively. Recurrence was observed in 6.5% of patients at 2 years, with 4 requiring repeat urethroplasty. Symptom improvement was reported by 95% of patients at 1-3 months and 88.1% at 2 years.

Conclusions: Dorsal onlay labial mucosal graft urethroplasty is a safe and effective treatment for FUS, with high success rates, minimal complications, and durable outcomes. This study, the largest single-surgeon series, highlights the utility of this approach as a reliable option for managing this underdiagnosed condition.

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女性尿道狭窄的背侧唇黏膜移植尿道成形术：同一外科医生200例以上的结果。

目的：评估女性尿道狭窄（FUS）的背侧唇黏膜移植尿道成形术的结果，由于非特异性症状和诊断局限性，这种情况仍然具有挑战性，并且经常被误诊。方法：回顾性分析一个前瞻性维护的数据库，包括2013年6月至2024年7月期间接受背侧唇黏膜移植尿道成形术治疗FUS的204例患者。如果患者通过尿流测量、排尿膀胱尿道造影（MCU）或尿道校准证实有症状性FUS，则纳入患者。评估的结果包括临床成功率、复发率、并发症和基于总体改善印象（GII）的主观改善。结果：平均手术时间97.7±13分钟，平均住院时间2天（2 ~ 11天）。围手术期并发症极少，Clavien-Dindo 2-3级并发症6例（2.94%），供体部位无明显并发症。中位随访29个月（范围：7-231），1-3个月、6个月和2年的临床成功率分别为98.5%、97.5%和93.5%。6.5%的患者在2年后出现复发，其中4例需要重复尿道成形术。95%的患者在1-3个月时症状改善，88.1%在2年时症状改善。结论：背侧唇黏膜移植尿道成形术是一种安全有效的治疗FUS的方法，成功率高，并发症少，效果持久。这项研究是最大的单外科医生系列研究，强调了这种方法作为治疗这种未被诊断的疾病的可靠选择的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.