Diagnostics, reconstructive approaches, and outcomes in female urethroplasty patients

Objectives

To gain further understanding of current outcomes regarding urethroplasty for female urethral stricture disease.

Methods

The European Association of Urology Section of Genitourinary Reconstructive Surgeons formed the Female Reconstruction Group to enhance multicentric collaboration, and to generate more evidence on the most effective treatment options for female patients with recurrent urethral stricture. Patients were eligible for inclusion if they had a urethral stricture and had undergone one of three reconstructive procedures, namely ventral onlay flap (VOFU), ventral onlay graft (VOGU) or dorsal onlay graft (DOGU) urethroplasty. Outcomes of specific interest were stricture-free survival and prognostic factors.

Results

Of a total of 165 included patients, the surgical techniques were VOFU, VOGU, DOGU in 17, 115 and 33 patients, respectively. The median follow-up was 29 months. The 2-year stricture-free survival rate was 73%, 86% and 80% in respectively the VOFU, VOGU and DOGU groups, with no significant difference between the groups. Prior radiotherapy (P = 0.015) was identified as an independent predictor for stricture recurrence.

Conclusion

Female urethroplasty is a safe treatment option with excellent patency rates. Mid-term stricture-free survival rate after different types of urethroplasty is encouraging in females.