Comparing ventral and dorsal oral mucosal graft urethroplasty in female urethral stricture: a systematic review and meta-analysis.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Mazhar Ortac, M Firat Ozervarli, Rifat Burak Ergul, Arda Tunc Aydinoglu, Mevlut Melih Bicer, Teresa Olsen Ekerhult, Senol Tonyali, Assoc Prof
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引用次数: 0

Abstract

Purpose: Reconstructive surgical options have become an alternative for female urethral stricture. Dorsal and ventral methods using oral mucosa grafts have been described, but their superiority over each other has not been evaluated. In this meta-analysis, the outcomes of dorsal and ventral techniques with oral mucosa graft in female urethroplasty have been compared.

Material and method: A systematic search of Pubmed, Scopus and Web of Science databases was performed according to the Preferred Reporting Items For Systematic Review And Meta-Analysis statement. Manuscripts published until February 2025 that reported the use of dorsal or ventral surgical approaches with oral mucosa grafts in female urethroplasty included. Success, determined based on the recurrence rate, was analyzed and compared between both groups. Complications were presented in both groups to evaluate the safety of the surgical technique.

Results: A total of 320 studies were identified, with 25 meeting the inclusion criteria. The meta-analysis, including four comparative cohort studies, showed no significant difference in surgical success between the dorsal (62/69 patients) and ventral (93/103 patients) techniques (OR = 0.84, 95% CI: 0.30-2.36, p = 0.74). In the pooled analysis combining both comparative and non-comparative studies, the success rates for the dorsal and ventral techniques were 92.1% (95% CI: 89.1-95.1) and 95.5% (95% CI: 92.8-98.2), respectively, with no significant heterogeneity. A total of 4 cases of stress urinary incontinence complications were reported in the ventral approach, while 2 cases were reported using the dorsal approach. The majority of the studies (21 out of 25) provided Level 4 evidence, with only two randomized controlled trials reaching Level 2.

Conclusion: This meta-analysis confirms that both dorsal and ventral approaches are effective for treating female urethral stricture, with high success rates. There was no statistically significant difference in success rates between the ventral and dorsal approaches. Surgical approach selection should depend on patient factors and surgeon expertise to achieve optimal outcomes.

比较腹侧和背侧口腔黏膜移植尿道成形术治疗女性尿道狭窄:系统回顾和荟萃分析。
目的:尿道再造术已成为女性尿道狭窄的另一种治疗方法。背侧和腹侧的口腔粘膜移植方法已经被描述过,但它们之间的优势还没有被评估过。在这项荟萃分析中,比较了背侧技术和腹侧技术联合口腔黏膜移植在女性尿道成形术中的效果。材料和方法:系统检索Pubmed、Scopus和Web of Science数据库,根据系统评价和meta分析的首选报告项目声明。截至2025年2月发表的报道女性尿道成形术中使用背侧或腹侧手术入路口腔黏膜移植的手稿包括在内。以复发率为标准,对两组患者的治疗成功率进行分析和比较。两组均出现并发症,以评估手术技术的安全性。结果:共纳入320项研究,其中25项符合纳入标准。meta分析包括4项比较队列研究,结果显示背侧(62/69例)和腹侧(93/103例)手术成功率无显著差异(OR = 0.84, 95% CI: 0.30-2.36, p = 0.74)。在结合比较和非比较研究的汇总分析中,背侧和腹侧技术的成功率分别为92.1% (95% CI: 89.1-95.1)和95.5% (95% CI: 92.8-98.2),没有显著的异质性。报告腹侧入路出现压力性尿失禁并发症4例,背侧入路2例。大多数研究(25个研究中有21个)提供了4级证据,只有两个随机对照试验达到了2级。结论:本荟萃分析证实,背侧和腹侧入路治疗女性尿道狭窄均有效,成功率高。腹侧入路和背侧入路的成功率无统计学差异。手术入路的选择应取决于患者因素和外科医生的专业知识,以达到最佳效果。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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