Neurourology and urodynamics · 2025
Short-Term Outcomes Following Transurethral Dorsal Buccal Graft Urethroplasty for Female Urethral Strictures.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Jefferson Francis A, Lee Yeonsoo Sara, Rafetto Anessa N, Balzano Felicia, Cohen Tal, Linder Brian J, Warner J N
Аннотация
INTRODUCTION AND OBJECTIVES: Female urethral strictures remain a challenging clinical entity with limited data on optimal reconstructive techniques. This study presents 12-month clinical and patient-reported outcomes following a novel transurethral approach to dorsal inlay buccal graft urethroplasty.
METHODS: We evaluate the outcomes of consecutive female patients with urethral strictures treated via dorsal inlay buccal graft urethroplasty from October 2021 to November 2024. Preoperative evaluation included cystoscopy, uroflowmetry, and/or voiding cystourethrogram. Follow-up at 4 and 12 months included cystoscopy, uroflowmetry, and patient-reported outcomes measured via the Global Response Assessment. Success was defined as absence of recurrence on cystourethroscopy.
RESULTS: Twenty-one patients were included in the study, with 95% having undergone prior treatments (90% dilation/DVIU and 9% urethroplasty). Stricture locations varied across the distal (33%), mid (19%), proximal (19%), and multifocal/pan urethral (19%). The median operative duration was 60 min (IQR: 56-86) and all were discharged on the day of surgery. Nineteen patients (90%) underwent a dorsal inlay procedure, while two (10%) required combined dorsal and ventral inlay due to obliterative stricture. No complications were observed. The median follow-up was 13.2 (IQR: 5.1-23.5) months, during which time 1 patient underwent retreatment for recurrent stricture. Clinical success was 95% at 4 months and 92% at 12 months. Median peak urinary flow rate preoperatively versus 4-month postoperatively was 7.0 cc/s versus 13.0 cc/s (p = 0.20) and at 12-month postoperatively was 13.3 cc/s (p = 0.50). 90% of patients reported improvement on the Global Response Assessment. There were no cases of de novo stress urinary incontinence.
CONCLUSIONS: This novel transurethral dorsal inlay buccal graft urethroplasty offers a safe and efficient treatment for female urethral strictures with durable clinical and patient-reported outcomes at 12 months. The technique's minimal urethral mobilization translates into shorter operative times and a low risk of stress incontinence, making it a promising alternative to traditional approaches.
METHODS: We evaluate the outcomes of consecutive female patients with urethral strictures treated via dorsal inlay buccal graft urethroplasty from October 2021 to November 2024. Preoperative evaluation included cystoscopy, uroflowmetry, and/or voiding cystourethrogram. Follow-up at 4 and 12 months included cystoscopy, uroflowmetry, and patient-reported outcomes measured via the Global Response Assessment. Success was defined as absence of recurrence on cystourethroscopy.
RESULTS: Twenty-one patients were included in the study, with 95% having undergone prior treatments (90% dilation/DVIU and 9% urethroplasty). Stricture locations varied across the distal (33%), mid (19%), proximal (19%), and multifocal/pan urethral (19%). The median operative duration was 60 min (IQR: 56-86) and all were discharged on the day of surgery. Nineteen patients (90%) underwent a dorsal inlay procedure, while two (10%) required combined dorsal and ventral inlay due to obliterative stricture. No complications were observed. The median follow-up was 13.2 (IQR: 5.1-23.5) months, during which time 1 patient underwent retreatment for recurrent stricture. Clinical success was 95% at 4 months and 92% at 12 months. Median peak urinary flow rate preoperatively versus 4-month postoperatively was 7.0 cc/s versus 13.0 cc/s (p = 0.20) and at 12-month postoperatively was 13.3 cc/s (p = 0.50). 90% of patients reported improvement on the Global Response Assessment. There were no cases of de novo stress urinary incontinence.
CONCLUSIONS: This novel transurethral dorsal inlay buccal graft urethroplasty offers a safe and efficient treatment for female urethral strictures with durable clinical and patient-reported outcomes at 12 months. The technique's minimal urethral mobilization translates into shorter operative times and a low risk of stress incontinence, making it a promising alternative to traditional approaches.