Detrusor Underactivity Research Articles

Treatment outcomes of detrusor underactivity in women based on clinical and videourodynamic characteristics.

Treatment of voiding dysfunction due to detrusor underactivity (DU) remains challenging. This study sought to determine the characteristics of video urodynamic study (VUDS) in female DU and outcomes after active treatment. A total of 409 female patients with VUDS-proven DU were recruited. All patients received conservative bladder management, with others receiving active treatment, such as oral medication, transurethral incision of bladder neck (TUI-BN), surgery for prolapse, and urethral botulinum toxin A (BoNT-A) injection, according to their VUDS characteristics. Treatment outcomes were then analyzed by different VUDS characteristics. Satisfactory treatment outcomes were noted in 123 patients (30.0%), among whom 35 and 88 had a VE of > 90% and > 66.7%, respectively. A total of 165 patients (40.3%) had voiding efficiency (VE) of 33.3-66.7%, whereas 121 (29.6%) remained unable to void (12.5%) or had a VE of < 33.3% (17.1%). Conservative treatment had the worst outcome. Patients with normal or slightly reduced bladder sensation (49.3%) and those with a post-void residual (PVR) of < 250mL (59.4%) displayed better satisfactory outcome after treatment; while TUI-BN and urethral BoNT-A injection promoted better treatment results. Patients with detrusor acontractility and a PVR of ≥ 500mL still achieved high VE rates (> 66.7%) after TUI-BN. A 56.3% satisfactory outcome was achieved after TUI-BN, whereas 58.1% satisfactory outcome was noted in those with a tight external sphincter after medical treatment. Female patients with DU exhibited VE improvement after active treatment. Patients with very low detrusor contractility and absent bladder sensation generally exhibited poor treatment outcomes.

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

Background and objectives: The aim of this systematic review is to evaluate the impact of radical prostatectomy (RP) on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation. Materials and Methods: The review was performed in accordance with the PRISMA statement and was registered in the PROSPERO (ID#: CRD42020223480). The studied population was limited to men with prostate cancer who underwent urodynamic study prior to and after radical prostatectomy. Eight hundred twenty-seven studies were screened, with twenty-five finally included. A qualitative analysis was performed. Rates of detrusor underactivity (DU) before surgery were reported in eight studies and ranged from 1.6% to 75% (median of 40.8%). DU occurred de novo after RP in 9.1% to 37% of patients (median of 29.1%). On the other hand, preexisting DU resolved in 7% to 35.5% of affected men. Detrusor overactivity (DO) was the most frequently reported outcome, being assessed in 23 studies. The rate of DO preoperatively was from 5% to 76% (median of 25%). De novo was reported in 2.3–54.4% of patients (median of 15%) and resolved after RP in 19.6% to 87.5% (median of 33%) of affected patients. Baseline rates of bladder outlet obstruction (BOO) varied between studies from 19% to 59.3%, with a median of 27.8%. The most pronounced change after surgery was the resolution of BOO in 88% to 93.8% (median of 92%) of affected patients. Results: Rates of de novo impaired bladder compliance (IBC) varied from 3.2% to 41.3% (median of 13.3%), whereas the resolution of IBC was reported with rates ranging from 0% to 47% (median of 4.8%). Conclusions: BOO, DO, and DU are frequently diagnosed in men scheduled for RP. BOO is improved after RP in most patients; however, there is still a substantial rate of patients with de novo DU as well as DO which may impair functional outcomes and quality of life.

Underactive and low compliance bladder: A possible Presentation of COVID-19 vaccination

Vaccine-related adverse events have been increasingly reported as the COVID-19 vaccination campaign progresses worldwide. Urological symptoms after COVID-19 vaccination are reported rarely. Herein, we report a case of urinary retention following the second dose of Oxford/AstraZeneca COVID-19 vaccine injection.

DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction.

Objectives To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn's multiple comparisons test, and Spearman's correlation test was used. Results DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions Low urothelial ATP parallels with a high incidence of DU early after pBOO.

Sacral neuromodulation in patients with detrusor underactivity: Is biological sex an indicator?

This study aimed to report sacral neuromodulation (SNM) outcomes in detrusor underactivity (DU). A multicentric, multinational, retrospective case series was conducted between March 2017 and June 2021 in three different referral centers. Initial test phase stimulation included either a percutaneous nerve evaluation (PNE) or an advanced lead evaluation test phase (ALTP) before permanent SNM implantation. The test phases were performed under local anesthesia, either in the outpatient (PNE) or operating room (ALTP), in the prone position, which was implanted in the third or fourth sacral foramina under fluoroscopic guidance. Patients with favorable response to the initial test phase during the first 2 weeks underwent the implantable pulse generator (IPG) implantation (Medtronic neurostimulation generator device InterStim™). Favorable response was defined as ≥ 50% improvement in symptoms, frequency of clean intermittent catheterization (CIC) and/or decrease in postvoid residual (PVR), increase in voided volume, or improvement in bladder voiding efficiency (BVE) based on the bladder diary. Fifty-eight patients were recruited with a mean age of 39.95 ± 15.28 years. Among the 58 cases, 36 (62.1%) patients responded to the initial stage. Of these, 12 patients (30.8%) with non-neurogenic etiology and nine patients (52.9%) with neurologic etiology did not respond to the initial test phase; thus, they did not undergo full implantation (p = 0.141). Voided volume, PVR, and the median maximum flow rate (Qmax) improved significantly (p < 0.001) in both sexes; however, there was no statistical difference between both genders. Most female cases (78.3%), and nearly half of the men (51.4%), responded to the test phase and were candidates for the IPG phase. Among the 35 cases who underwent IPG, 27 patients (72.2% of males, and 77.8% of females; p = 0.700) had a favorable response to IPG. 46.6% of patients had a successful outcome at the end of the study. This multicentric study showed that SNM effectively and safely provided symptom improvement in refractory DU in males similar to females which is an important finding as previously it has been suggested that SNM works better in nonobstructive urinary retention in women and not in women.

Validation and clinical utility of the diagnostic criteria for detrusor underactivity in men proposed by the Japanese Continence Society.

Validation and clinical utility of the diagnostic criteria for detrusor underactivity in men proposed by the Japanese Continence Society.

Therapeutic effect of adipose stromal vascular fraction spheroids for partial bladder outlet obstruction induced underactive bladder

BackgroundUnderactive bladder (UAB) is a common clinical problem but related research is rarely explored. As there are currently no effective therapies, the administration of adipose stromal vascular fraction (ad-SVF) provides a new potential method to treat underactive bladder.MethodsMale Sprague–Dawley rats were induced by partial bladder outlet obstruction (PBOO) for four weeks and randomly divided into three groups: rats treated with PBS (Sham group); rats administrated with ad-SVF (ad-SVF group) and rats performed with ad-SVF spheroids (ad-SVFsp group). After four weeks, urodynamic studies were performed to evaluate bladder functions and all rats were sacrificed for further studies.ResultsWe observed that the bladder functions and symptoms of UAB were significantly improved in the ad-SVFsp group than that in the Sham group and ad-SVF group. Meanwhile, our data showed that ad-SVF spheroids could remarkably promote angiogenesis, suppress cell apoptosis and stimulate cell proliferation in bladder tissue than that in the other two groups. Moreover, ad-SVF spheroids increased the expression levels of bFGF, HGF and VEGF-A than ad-SVF. IVIS Spectrum small-animal in vivo imaging system revealed that ad-SVF spheroids could increase the retention rate of transplanted cells in bladder tissue.ConclusionsAd-SVF spheroids improved functions and symptoms of bladder induced by PBOO, which contributes to promote angiogenesis, suppress cell apoptosis and stimulate cell proliferation. Ad-SVF spheroids provide a potential treatment for the future patients with UAB.

A0848 - Bladder NIRS: A non-invasive method functional to distinguish between detrusor underactivity (DU) and Bladder Outlet Obstruction (BOO) in men with LUTS

A0848 - Bladder NIRS: A non-invasive method functional to distinguish between detrusor underactivity (DU) and Bladder Outlet Obstruction (BOO) in men with LUTS

A0853 - Bladder outlet obstruction or underactive bladder?

A0853 - Bladder outlet obstruction or underactive bladder?

A0849 - 10-year follow-up observation of idiopathic detrusor underactivity in the elderly living in community: Treatment and urodynamic changes

A0849 - 10-year follow-up observation of idiopathic detrusor underactivity in the elderly living in community: Treatment and urodynamic changes

A0702 - Bladder cryo-injury induced detrusor underactivity rat model: Early effects of adipose-derived stem cell sheet and their differentiation

A0702 - Bladder cryo-injury induced detrusor underactivity rat model: Early effects of adipose-derived stem cell sheet and their differentiation

Clinical features of detrusor underactivity in elderly men without neurological disorders.

To investigate the clinical features of detrusor underactivity (DU) in elderly men without neurological disorders. A total of 336 men aged ≥50 years without neurogenic disorders who underwent pressure flow studies and who had DU or bladder outlet obstruction (BOO) were reviewed retrospectively. According to the bladder contractility index (BCI) and the BOO index (BOOI), the subjects were classified into the following three groups: (a) pure DU group, BCI < 100 and BOOI < 40; (b) DU + BOO group, BCI < 100 and BOOI ≥ 40; and (c) pure BOO group, BCI ≥ 100 and BOOI ≥ 40. Subjective and objective parameters were compared among the three groups, and the predictors for pure DU were evaluated by multivariate analysis. Of the 336 patients, 205 who met the study criteria were included in the analysis: 63 (30.7%) with pure DU, 48 (23.4%) with DU + BOO, and 94 (45.9%) with pure BOO. The proportion of the pure DU group increased with increasing age. Prostate volume was the lowest in the pure DU group. Frequency, urgency on the International Prostate Symptom Score (IPSS), and the IPSS storage subscore were the lowest in the pure DU group. Multivariate analysis showed that age (odds ratio [OR] 1.114 [95% CI, 1.032-1.203], P=.005), prostate volume (OR 0.968 [95% CI, 0.949-0.987], P=.001), and urgency (OR 0.623 [95% CI, 0.431-0.900], P=.012) were predictors of pure DU. Older age, smaller prostate volume, and less urgency may be clinical features of pure DU.

The influence of intubation on urinary flow parameters in pressure-flow study and its significance for urodynamic diagnosis.

Transurethral catheterization in pressure-flow study (PFS) may interfere with the function of the lower urinary tract and produce an incorrect urodynamic diagnosis. We aimed to investigate the influence of a 7F catheter on urinary flow parameters in PFS and its significance for urodynamic diagnosis. Our hypothesis was that intubation causes adverse effects on urinary flow rate and further influences the urodynamic diagnosis. We reviewed a urodynamic database of men and women referred for evaluation of lower urinary tract symptoms. The urinary flow parameters of PFS and free flow (FF) were compared. The influence of intubation on urodynamic diagnosis was determined by re-evaluating bladder outlet obstruction (BOO) and detrusor underactivity (DU), with the maximum flow rate of PFS (Qmax.P) being replaced by Qmax of FF (Qmax.F). We initially screened 1,791 patients and included 1,144 for the analysis. Overall, PFS had a lower Qmax (p< 0.001), longer flow time (p < 0.001), and a similar voided volume (p> 0.05). However, Qmax.P displayed inconsistent changing directions: Qmax.P decreased in 72.8% of male patients and 83.5% of female patients but increased in 14.7% of male patients and 9.5% female patients. Qmax.P was unchanged in the remaining patients. The urodynamic diagnosis of BOO and DU changed correspondingly in both the decreased group and the increased group when Qmax.P was replaced by Qmax.F. Compared with Qmax.F, the changing directions and magnitude of Qmax.P varied with each individual, which could have a significant impact on urodynamic diagnosis. Thus, when a similar volume is voided in FF and PFS, and Qmax.P differs obviously from Qmax.F, replacing Qmax.P with Qmax.F for evaluating BOO and DU may be a sensible choice.

The Clinical Features and Predictive Factors of Nocturnal Enuresis in Adult Women.

ObjectiveOur current knowledge on nocturnal enuresis (NE) in adults is scarce due to its uncommon nature. The present study was designed to investigate symptom characteristics and risk factors of NE in adult women to improve the current clinical understanding and management of this rare disease.MethodsOver a 3-year period, we enrolled 70 adult women who complained of bedwetting, with a frequency of at least once per week and a symptom duration of 3 months or longer. Patients were excluded if they had known pregnancy, current urinary tract infection, untreated malignancies, anatomical abnormalities, and irregular sleep cycle. The International Consultation on Incontinence Modular Questionnaire—female lower urinary tract symptoms and bladder diary were employed to appraise lower urinary tract symptoms and voiding behavior. Urodynamics was performed to assess the bladder function. A linear regression analysis was applied to determine potential risk factors for NE frequency.ResultsAmong the recruited subjects, comorbidities and lower urinary tract symptoms were frequently reported. On bladder diary, patients commonly presented with nocturnal polyuria (NP), reduced nocturnal voided volumes (RNVVs), or both. Urodynamics revealed multiple dysfunctions, namely, detrusor overactivity (DO), urodynamic stress incontinence (USI), reduced compliance, bladder outlet obstruction, detrusor underactivity (DU), and simultaneous DO and DU. Patients with more frequent NE (≥4/week) demonstrated markedly increased body mass index, more comorbid conditions, worse incontinence symptoms, NP or NP plus RNVVs, reduced compliance, and poorer voiding possibly owing to DU. Whereas, RNVVs alone and worse overactive bladder-related parameters were associated with milder NE. Multivariate analysis indicated that frequency/urgency quality of life, incontinence symptom, NP + RNVVs, poor flow, increased bladder sensation, USI, and simultaneous detrusor overactivity plus DU were independent risk factors for NE severity.ConclusionNE in adult women may have both urological and non-urological pathophysiology. Imbalanced circadian urine production, jeopardized continence mechanisms, overactive bladder, and DU-induced poor voiding are major factors that contribute to the pathogenesis of NE in adult women. Focused treatments on restoring these functions should be individually considered.

Therapeutic outcome of active management in male patients with detrusor underactivity based on clinical diagnosis and videourodynamic classification

Detrusor underactivity (DU) could be resulted from many different etiologies. Patients with DU might have reduced bladder sensation, low detrusor contractility, and large post-void residual volume. This study analyzed therapeutic outcome of active management for male DU patients, based on clinical and urodynamic characteristics. Male DU patients aged > 18 years old were retrospectively reviewed from the videourodynamic study (VUDS) records in recent 10 years. The patients’ demographics, VUDS results, treatment modalities, and treatment outcome were analyzed. The treatment outcomes were compared among patients with different DU subgroups, clinical diagnosis and treatment modalities. Patients with voiding efficiency of > 66.7% were considered having a successful treatment outcome. For comparison, 30 men with normal VUDS finding served as the control arm. Most of the DU patients had reduced bladder sensation. The reduced bladder sensation is closely associated with low detrusor contractility. After active treatment, a successful outcome was achieved in 68.4% of patients after bladder outlet surgery, 59.1% after urethral botulinum toxin A injection, and 57.6% after medical treatment, but only 18.2% after conservative treatment. A successful treatment outcome was achieved in patients with an intact detrusor contractility, either low (69.2%) or normal voiding pressure (81.8%), and in patients with a normal or increased bladder sensation (78.1%). However, patients with detrusor acontractile (41.3%) or absent bladder sensation (17.9%) had less favorable treatment outcome after any kind of urological management. This study revealed that active management can effectively improve voiding efficiency in patients with DU. The normal bladder sensation, presence of adequate detrusor contractility, and bladder outlet narrowing during VUDS provide effective treatment strategy for DU patients. Among all management, BOO surgery provides the best treatment outcome.

Feasibility of a deep learning-based diagnostic platform to evaluate lower urinary tract disorders in men using simple uroflowmetry.

PurposeTo diagnose lower urinary tract symptoms (LUTS) in a noninvasive manner, we created a prediction model for bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using simple uroflowmetry. In this study, we used deep learning to analyze simple uroflowmetry.Materials and MethodsWe performed a retrospective review of 4,835 male patients aged ≥40 years who underwent a urodynamic study at a single center. We excluded patients with a disease or a history of surgery that could affect LUTS. A total of 1,792 patients were included in the study. We extracted a simple uroflowmetry graph automatically using the ABBYY Flexicapture® image capture program (ABBYY, Moscow, Russia). We applied a convolutional neural network (CNN), a deep learning method to predict DUA and BOO. A 5-fold cross-validation average value of the area under the receiver operating characteristic (AUROC) curve was chosen as an evaluation metric. When it comes to binary classification, this metric provides a richer measure of classification performance. Additionally, we provided the corresponding average precision-recall (PR) curves.ResultsAmong the 1,792 patients, 482 (26.90%) had BOO, and 893 (49.83%) had DUA. The average AUROC scores of DUA and BOO, which were measured using 5-fold cross-validation, were 73.30% (mean average precision [mAP]=0.70) and 72.23% (mAP=0.45), respectively.ConclusionsOur study suggests that it is possible to differentiate DUA from non-DUA and BOO from non-BOO using a simple uroflowmetry graph with a fine-tuned VGG16, which is a well-known CNN model.

Association between Urodynamic and Cystoscopic findings in Women with Bothersome Lower Urinary Tract Symptoms: A Prospective Observational Study

Introduction: Lower Urinary Tract Symptoms (LUTS) are responsible for negative impact on quality of life of women. Urodynamic Study (UDS) is gold standard objective investigation in evaluating bothersome LUTS. Cystoscopy is important where UDS is difficult or unavailable. Despite vital role and unique properties of UDS and cystoscopy, the role of UDS and cystoscopy in the assessment of bothersome LUTS in young females continues to be heavily debatable subject as there is limited study in this age group. Aim: To evaluate causes of LUTS in young female patients and associate them with urodynamic and cystoscopic findings. Materials and Methods: This was a prospective observational study conducted in IPGMER and SSKM Hospital, Kolkata, West Bengal, India, from July 2019 to December 2020. A total of 100 female patients from adulthood to menopause were evaluated having decreased quality of life due to LUTS called bothersome LUTS in the form of history taking, clinical examination, basic biochemical tests, ultrasonography followed by urodynamic and cystoscopic examination. Patients were classified according to their LUTS into three groups: storage dysfunction, urinary incontinence and bladder emptying dysfunction. Association of UDS parameters like Idiopathic Detrusor Overactivity (IDO), IDO with detrusor underactivity, Compensated Bladder Outlet Obstruction (CBOO) was made with cystoscopic findings like dilated veins with cystitis,lax urethra, bladder trabeculations,diverticula, urethral stricture. Results were analyzed using Microsoft Excel spreadsheet and International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 27.0. Results: In storage dysfunction group, frequency with nocturia (53.3%) and in urinary incontinence group, stress urinary incontinence (58.3%) was predominant bothersome symptom. In storage dysfunction group 73.3% patients had IDO and 26.7% patients had normal UDS findings. In these patients on cystoscopic examination, 83.3% patients had dilated veins with cystitis changes. In urinary incontinence group 70.8% patients had IDO and 29.2% patients had IDO with detrusor underactivity on UDS examination. In these patients cystoscopic examination 54.2% had lax urethra with cystitis changes. In bladder emptying dysfunction group on UDS examination, all patients had CBOO and 75% had urethral stricture on cystoscopy. Conclusion: Significant association exists between UDS and cystoscopic findings on evaluation of LUTS in young females patients. Storage dysfunction symptoms were the most common in young age group followed by urinary incontinence symptoms. Bladder emptying dysfunction symptoms were least common.

Changes in transient receptor potential vanilloid 1 and transient receptor potential vanilloid 4 in patients with lower urinary tract dysfunction.

PurposeWe investigated the association between transient receptor potential vanilloid (TRPV) expression in human urothelium tissue and lower urinary tract dysfunction (LUTD).Materials and MethodsWe prospectively enrolled men who planned to undergo surgical treatment for benign prostatic obstruction to analyze TRPV1 and TRPV4 expression in the urothelium using enzyme-linked immunosorbent assay and immunofluorescence staining. Patients were divided into two groups based on urodynamics: the detrusor underactivity (DU) group and the non-DU group. Levels of TRPV1 and TRPV4 were compared between the two groups. We also divided patients into two groups according to degree of subjective urinary urgency symptoms using a 5-point urinary sensation scale and compared the differences in TRPV1 and TRPV4 levels between the two groups. The correlations between urodynamic parameters with TRPV1 or TRPV 4 in all patients were also analyzed.ResultsThe levels of TRPV1 and TRPV 4 were not significantly different between the DU group (n=10) and the non-DU group (n=11). When we divided the patients according to degree of subjective urgency, the level of TRPV1 was not significantly different between the urgency group (n=10) and the non-urgency group (n =11), but the level of TRPV4 was significantly increased in the urgency group (p=0.029). There was no significant correlation between the level of TRPV1 or TRPV4 and urodynamic parameters in any patients.ConclusionsTRPV4 could be a useful diagnostic biomarker for patients with LUTD.

Urodynamic profile of lower urinary tract symptoms in young men: A testimony of the truth?

Aim:To evaluate the impact of urodynamic study (UDS) in the management of young men presenting with lower urinary tract symptoms (LUTSs).Materials and Methods:This is a retrospective, observational study of urodynamic findings of 128 patients presented with LUTS at the Department of Urology, Institute of Nephrourology, Bangalore, over a period of 5 years (August 2014 to July 2019). Pre- and post-UDS diagnoses as well as treatment modalities were compared to evaluate the usefulness of UDS.Results:A total of 110 patients (86%) had abnormal UDS findings. Before UDS, 55 (43%) patients were clinically diagnosed for overactive bladder; after UDS, bladder outlet obstruction (BOO) was seen in 32 (25%) patients and detrusor overactivity in 18 (14.1%). Clinically, BOO was diagnosed in 36 (28.1%) patients; however, urodynamic findings of BOO were seen only in 23 (18%) patients. Pre-UDS, bladder underactivity was suspected in 23 (18%); however, underactive detrusor was noted in 20 (15.6%) patients, and 3 (2.4%) patients were normal on UDS. Post-UDS, antibiotics were not prescribed to anyone. 18 (14%) patients underwent surgery after UDS confirmation of BOO. 67 patients (52.3%) had their clinical diagnosis changed following UDS. Concomitant changes in the management were required for 59 patients (46%).Conclusion:Etiologies of LUTSs in young men are more varied. Clinical diagnosis and treatment are often empirical and inaccurate. UDS is useful to achieve accurate diagnosis and to guide appropriate treatment. Video urodyanamics should be used to evaluate LUTS in young men.

Outcome Analysis of Dorsal Buccal Mucosal Graft Urethroplasty in Perimenopausal Women with Urethral Stricture Disease

Purpose: To assess the clinical outcomes following dorsal buccal mucosal graft urethroplasty (BMGU) in perimenopausal women (PMW) suffering from urethral stricture disease. Materials and Methods: PMW (40–65 years) presenting with urinary symptoms were evaluated with uroflowmetry, voiding cystourethrogram (VCUG), and urethral calibration. PMW with maximum flow rate (Qmax) less than 10 ml/s or postvoid residual (PVR) volume greater than 50 ml, VCUG showing evidence of urethral stricture, and failure to calibrate with 14 Fr Foley catheter were included in the study. Patients with underactive bladder, carcinoma cervix, pelvic trauma, and oral submucosal fibrosis were excluded from the study. Patients satisfying inclusion and exclusion criteria underwent dorsal BMGU. Outcomes of the surgery were assessed by uroflowmetry at 3-monthly intervals. Results: The number of patients satisfying the inclusion and exclusion criteria between March 2014 and March 2020 was eight. The mean age of the patients was 52.1 years. The mean stricture length was 1.9 cm. The mean preoperative Qmax and PVR were 4.2 ml/s and 110 ml, respectively. The mean postoperative Qmax and PVR at 6 months were 15.4 ml/s and 39.1 ml, respectively. One patient had a recurrent stricture and underwent dilatation. Donor site complications were minor. The overall success rate of the procedure was 87%. Conclusion: Dorsal BMGU in females for urethral stricture disease offers successful urethral reconstruction and the advantage of least disruption of continence mechanism and resilience to hormonal changes in PMW.