PD16-05 LONG TERM RESULTS OF FEMALE URETHRAL RECONSTRUCTION USING DORSAL ONLAY LINGUAL MUCOSAL GRAFT

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I1 Apr 2016PD16-05 LONG TERM RESULTS OF FEMALE URETHRAL RECONSTRUCTION USING DORSAL ONLAY LINGUAL MUCOSAL GRAFT Sameer Trivedi, Udai Shankar Dwivedi, Sartaj Wali Khan, V S Rathee, Pushpendra Shukla, and Aditya Kumar Singh Sameer TrivediSameer Trivedi More articles by this author , Udai Shankar DwivediUdai Shankar Dwivedi More articles by this author , Sartaj Wali KhanSartaj Wali Khan More articles by this author , V S RatheeV S Rathee More articles by this author , Pushpendra ShuklaPushpendra Shukla More articles by this author , and Aditya Kumar SinghAditya Kumar Singh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1157AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urethral strictures are an uncommon cause of bladder outlet obstruction in females and are treated empirically with various modalities like dilatation and internal urethrotomy with varying outcomes. Female urethroplasty utilizing a variety of tissues (Vaginal or labial grafts/flaps, oral mucosal grafts) has been described with variable degree of success in short term but long term data are lacking. In this study, we have analyzed long term results of dorsal onlay lingual mucosal graft (LMG) urethroplasty in management of female urethral stricture. METHODS Between Oct 2006 & Oct 2010, 40 female patients diagnosed as having urethral stricture underwent LMG urethroplasty. Mean age was 44 years (23 – 71 years). Pre-operative mean Qmax was 7.5 ml/s (2.2 – 13.4 ml/s) and urethral calibration revealed a urethral lumen of <14 Fr in all patients. Dorsal onlay LMG urethroplasty was performed using the technique previously described by us. After 15 days, patients underwent a trial of voiding and VCUG. Patients were then followed at 3, 12, 24, 36, 48 and 60 months with uroflowmetry and a detailed questionnaire. VCUG was advised at 6- and 12-month follow-ups and cystoscopy performed if required. Criteria for successful reconstruction were a Qmax of =15 mL/s with no postoperative instrumentation. RESULTS Mean urethral stricture and harvested graft length were 2.45 cm and 2.95 cm, respectively. All patients showed symptomatic improvement with mean Qmax increasing from 7.5 ml/s to 28.7ml/s at 3 months. At 3 months, 5 patients had a Qmax<15ml/sec and 4 of these patients required urethral dilatation while 1 patient had a urethral lumen > 14 Fr and reported significant improvement. At 1 year, all 36 successful patients were symptom free with mean Qmax of 27.6 ml/s (18.2 ml/s – 37 ml/s). At 3 and 5 years, 4 out of 36 patients were lost to attrition. In the remaining 32 patients, mean Qmax was 26.3 ml/s and 25.8 ml/s at 3 and 5 years respectively. None of these patients required any ancillary procedures. Overall success rate was 90% with 4 out of 40 patients requiring urethral dilatations postoperatively. None of the patients reported any urinary incontinence. CONCLUSIONS Dorsal onlay LMG urethroplasty is a simple, safe & effective surgical option with good long term results in the management of female urethral stricture with minimal risk of urinary incontinence & high success rates. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e395-e396 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Sameer Trivedi More articles by this author Udai Shankar Dwivedi More articles by this author Sartaj Wali Khan More articles by this author V S Rathee More articles by this author Pushpendra Shukla More articles by this author Aditya Kumar Singh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...