{"title":"Buccal versus Vaginal Graft Urethroplasty in Female Urethral Stricture: A Systematic Review and Meta-Analysis.","authors":"Lalit Kumar, Anuja Thakur, Sakshi Agarwal, Mahesh Khairnar, Sameer Trivedi, Satya Narain Shankhwar","doi":"10.1007/s00192-025-06171-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study is aimed at comparing success rate, maximum flow rate (Q<sub>max</sub>), and post-void residual volume (PVR) between the buccal mucosal graft (BMG) and vaginal wall graft (VWG) through a meta-analysis of studies commonly performed by urogynecologists.</p><p><strong>Methods: </strong>A systematic review was performed in April 2024, including retrospective, prospective, and comparative studies excluding duplicates, review, editorial comments, case reports, systematic reviews, meta-analyses, and therapeutic indications. Heterogeneity in the meta-analysis was assessed using I<sup>2</sup> statistics.</p><p><strong>Results: </strong>The meta-analysis incorporated a quantitative assessment of 18 original articles. The studies in meta-analysis evaluated various parameters, including Q<sub>max</sub>, PVR, and success rates of surgical outcomes. The I<sup>2</sup> statistics indicated no heterogeneity in Q<sub>max</sub> and success rates between BMG and VWG, both with I<sup>2</sup> = 0% and high heterogeneity for PVR values (I<sup>2</sup> > 50%). According to the results, Q<sub>max</sub> values were 23.266 for BMG and 24.945 for VWG, PVR values were 14.651 for BMG and 23.009 for VWG, and success rates were 86.2% for BMG and 89.8% for VWG. A definition of success across the studies was established by achieving Q<sub>max</sub> > 15 ml/s at 3 months, a PVR < 30 ml, and an improvement in the American Urological Association symptom scores.</p><p><strong>Conclusions: </strong>Meta-analysis indicates no significant differences between VWG and BMG regarding Q<sub>max</sub>, PVR, and the overall success rate of surgical outcomes. Both BMG and VWG graft options demonstrate effectiveness in female urethroplasty. Graft choice should be based on graft availability and feasibility, patient characteristics, and the surgeon's preference and expertise.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urogynecology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00192-025-06171-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and hypothesis: This study is aimed at comparing success rate, maximum flow rate (Qmax), and post-void residual volume (PVR) between the buccal mucosal graft (BMG) and vaginal wall graft (VWG) through a meta-analysis of studies commonly performed by urogynecologists.
Methods: A systematic review was performed in April 2024, including retrospective, prospective, and comparative studies excluding duplicates, review, editorial comments, case reports, systematic reviews, meta-analyses, and therapeutic indications. Heterogeneity in the meta-analysis was assessed using I2 statistics.
Results: The meta-analysis incorporated a quantitative assessment of 18 original articles. The studies in meta-analysis evaluated various parameters, including Qmax, PVR, and success rates of surgical outcomes. The I2 statistics indicated no heterogeneity in Qmax and success rates between BMG and VWG, both with I2 = 0% and high heterogeneity for PVR values (I2 > 50%). According to the results, Qmax values were 23.266 for BMG and 24.945 for VWG, PVR values were 14.651 for BMG and 23.009 for VWG, and success rates were 86.2% for BMG and 89.8% for VWG. A definition of success across the studies was established by achieving Qmax > 15 ml/s at 3 months, a PVR < 30 ml, and an improvement in the American Urological Association symptom scores.
Conclusions: Meta-analysis indicates no significant differences between VWG and BMG regarding Qmax, PVR, and the overall success rate of surgical outcomes. Both BMG and VWG graft options demonstrate effectiveness in female urethroplasty. Graft choice should be based on graft availability and feasibility, patient characteristics, and the surgeon's preference and expertise.
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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