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21 May 2022 (Vol 45 , Iss 04 )

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31 May 2022 (Vol 45 , Iss 03 )

Journal ID : TMJ-30-11-2021-10832
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Title : Ventral Onlay Vaginal Graft Urethroplasty for Female Urethral Stricture Disease

Abstract :

Urethral stricture in female patients is rare, usually underdiagnosed and often overlooked. We aim to present our results in a series of woman surgically treated for urethral stricture disease using ventral onlay vaginal graft urethroplasty. All 3 women who were diagnosed with urethral stricture and underwent ventral onlay vaginal graft urethroplasty between October 2019 to October 2020 were included. All women were evaluated preoperatively including history, physical examination, uroflowmetry and Post Void Residual Urine measurement (PVR). Postoperative follow up included a series of standardized questions including if they had symptoms of urinary incontinence or urinary urgency. Follow up uroflowmetry and PVR was also performed in all patients. The criteria of successful reconstruction that we used were no reported subjective complaints from our patients, postoperative Qmax greater than 15ml/s with minimal post-void residue (<30 mL). Patient 1 had a significant increase in Qmax from 6.7 ml/s to 23.2 ml/s and the PVR were greatly reduced to 10.2 ml. Patient 2 went from urinary retention in preoperative period, to Qmax of 15.7 ml/s and PVR of 17.2 ml. Patient 3 had to undergo suprapubic cystostomy before the operation and the post-operative results were minimal post void residue (14.7 ml) with postoperative Qmax of 5.5 ml/s. All our patients had no persistent lower urinary tract symptoms, none reported urinary incontinence, bleeding, signs of infection and graft necrosis or vaginal bleeding. Urethroplasty using a ventral onlay vaginal graft may be considered as a first-line surgical option.

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