V10-08 DISTAL URETHRECTOMY AND ADVANCEMENT URETHROPLASTY FOR URETHRAL MEATUS STRICTURE IN FEMALE PATIENTS

Abstract

You have accessJournal of UrologyLower Tract Reconstruction (V10)1 Sep 2021V10-08 DISTAL URETHRECTOMY AND ADVANCEMENT URETHROPLASTY FOR URETHRAL MEATUS STRICTURE IN FEMALE PATIENTS Camille Haudebert, Juliette Hascoet, Lucas Freton, Andrea Manunta, Nirit Rosenblum, Benjamin Brucker, and Benoit Peyronnet Camille HaudebertCamille Haudebert More articles by this author , Juliette HascoetJuliette Hascoet More articles by this author , Lucas FretonLucas Freton More articles by this author , Andrea ManuntaAndrea Manunta More articles by this author , Nirit RosenblumNirit Rosenblum More articles by this author , Benjamin BruckerBenjamin Brucker More articles by this author , and Benoit PeyronnetBenoit Peyronnet More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002061.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Female urethral stricture is a rare condition. Distal stricture have usually been managed using meatoplasty. Advancement urethroplasty might be an interesting surgical alternative to meatoplasty. METHODS: We present the case of a 79 year-old female. She reported voiding symptoms for several years: slow stream, hesitancy and straining to void. On physical examination a narrowing of the urethral meatus is noted. The cystoscopy was not possible during the visit because of the stricture, the stricture could only be catheterized with a 12 Fr urethral dilator. We offered to do a distal urethrectomy and advancement urethroplasty. RESULTS: The stricture is easily identified on physical examination. Two holding stiches are place within the urethral lumen. An incision is made just above the dorsal aspect of the urethral meatus. The dorsal urethra is then opened longitudinally until healthy tissue is found above the stricture. Here the stricture is about one centimeter long. To confirm that the incision has reached healthy urethral tissue, an urethro-cystoscopy is performed. Before further pursuing the incision, the healthy urethra is sutured to the vaginal aspect of the incision at 12 o’clock to start the advancement urethroplasty using 5/0 pds. The incision is then carried out to the ventral circumference of the urethral meatus. The distal urethrectomy is completed, making sure to remove all the thickened fibrotic tissue. Additional stitches are placed all around the new urethral meatus to complete the advancement urethroplasty. An indwelling 16F urethral catheter is placed at the end of the procedure. The operative time was 30 minutes with minimal blood loss. There was no postoperative complications. The patient was discharged on postoperative day 2 and the urethral catheter on day 8. The patient resumed spontaneous voiding and was completely relieved of her voiding symptoms. She did not experience stress urinary incontinence postoperatively. CONCLUSIONS: Distal urethrectomy with advancement urethroplasty is safe and feasible in female patients with relatively short (up to 1 cm long) stricture of the distal urethra. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e757-e757 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Camille Haudebert More articles by this author Juliette Hascoet More articles by this author Lucas Freton More articles by this author Andrea Manunta More articles by this author Nirit Rosenblum More articles by this author Benjamin Brucker More articles by this author Benoit Peyronnet More articles by this author Expand All Advertisement Loading ...