MP76-18 A NOVEL QUANTITATIVE MEASURE OF BLADDER HYPER-SENSITIVITY IN ANALYSIS OF BLADDER DIARY WITH THE PATIENT'S SELF-REPORTED URINARY PERCEPTION GRADES

Abstract

popular graft material for male urethroplasty. Buccal mucosa grafting has been described in females, but not critically evaluated. We believe this represents the largest series of female patients using buccal mucosa having undergone the dorsal onlay buccal urethroplasty (DOBU). We hypothesize that this technique will have improved recurrence free rates, no fistula formation, improved post-op incontinence rates, and no greater risk of clitoral pain compared with ventral onlay, vaginal graft techniques. METHODS: A retrospective case series was compiled from 2009-13 identifying female subjects who underwent DOBU via suprameatal approach. All patients underwent pelvic exam, as well as supine stress test. Endpoints included recurrence of stricture verified by cystoscopy, uroflow, post-void residual, presence of urinary tract infection, pain, fistula formation, incontinence, and complications from both the donor site and the vagina. RESULTS: Six subjects were identified. Mean follow up was 16.9 months. No stress incontinence was noted pre-operatively, and none developed post-op. No fistulas were noted. Mean stricture length was 1.2cm and mean graft length was 2.75cm. One stricture recurrence was noted (16%) which required dilation. Mean pain score went from 3.5/10 to 0/10 on a 10 point Likert scale (p1⁄40.075). UTIs per year went from 4.3 to 0.3 (p1⁄40.038). Maximum voided velocity increased from 5.6 to 12.65 cc/sec (p1⁄40.049), and mean post void residual decreased from 305 to 41cc (p1⁄40.099). No urethral or vaginal complications were reported, but 2 patients reported donor site morbidity. No clitoral anesthesia or pain was reported. CONCLUSIONS: DOBU is durable and compares favorably with other reported techniques to repair female urethral stricture. It can be safely considered instead of vaginal graft urethroplasty using ventral onlay for the female with urethral stricture.