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Introduction: Lower urinary tract symptoms (LUTS) in the female patient can be a complex issue to accurately diagnose and treat. Physical exam occasionally reveals a narrow urethra, and cystoscopic evaluation may be limited for this reason. Historically, women noted to have urethral stenosis or narrowing were treated with urethral dilation. Success from this procedure is often short-lived. We describe a technique for distal urethroplasty, including a series of 7 female patients treated at our institution. A review of the literature on management of urethral stricture in women is included
Materials & Methods: Retrospective review of patients having undergone distal urethroplasty by a single surgeon at a tertiary academic medical center between April 1, 2013 and December 1, 2014. Specific focus is directed at presentation, surgical technique, and post-operative outcomes. The MEDLINE database was additionally searched for reports of management of female urethral stricture.
Results: Seven women were found to have significant LUTS with an isolated exam finding of urethral narrowing. Subjective symptoms improved post-operatively. Uroflow rates were obtained in three patients and increased flow velocity was noted in these cases. The literature review supports the idea that improved outcomes are noted with reconstructive techniques as opposed to urethral dilation.
Conclusions: Distal urethroplasty for female stricture demonstrates subjective improvement in bothersome LUTS. Based on available literature, reconstruction has higher rates of long term success. Future studies are needed to establish measurable criteria to assess and evaluate success pre- and post-operatively.