Schwender Catherine Elizabeth Bath, Ng Linda, McGuire Edward, Gormley E Ann
Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
J Urol. 2006 Mar;175(3 Pt 1):976-80; discussion 980. doi: 10.1016/S0022-5347(05)00336-8.
Urethral stricture disease in females is uncommon and is often treated with repeat dilation or internal urethrotomies. Various surgical techniques to repair strictures have been described with successful results. However, these techniques are cumbersome to use. The vaginal inlay flap is simple and easy to learn. To our knowledge this is the first report of its use and clinical results in a series of patients from 2 institutions.
Eight symptomatic women with a history of traumatic or difficult catheterization, a history of at least 1 urethral dilation or urethrotomy and difficult or a failed attempt at catheter placement underwent urethroplasty. The technique consisted of incising the posterior aspect of the stricture and advancing a vaginal inlay flap. A retrospective chart review was performed.
Followup was 1 to 9 years. All patients had subjective relief of symptoms and could easily catheterize with a 14Fr catheter. Average caliber of the urethra increased from 9.25Fr to 16.5Fr and post-void residual urine decreased from 130 to 15 cc. One patient with a hypotonic bladder was in retention, which resolved during 3 months. One patient underwent repeat dilation once 3 weeks after the primary procedure with no recurrence. No patient had stress urinary incontinence. There were no immediate or delayed serious complications.
Urethral stricture disease in females is an uncommon entity that can cause voiding symptoms, recurrent infections, retention and renal impairment. This method of surgical repair offers a durable result and has a low incidence of complications.
女性尿道狭窄疾病并不常见，通常采用反复扩张或内尿道切开术进行治疗。已有多种修复狭窄的手术技术被描述，且效果良好。然而，这些技术使用起来较为繁琐。阴道镶嵌皮瓣术简单易学。据我们所知，这是首次在来自2家机构的一系列患者中使用该技术及其临床结果的报告。
8例有创伤性或困难导尿史、至少有1次尿道扩张或尿道切开史且导尿困难或尝试失败的有症状女性接受了尿道成形术。该技术包括切开狭窄的后部并推进阴道镶嵌皮瓣。进行了回顾性病历审查。
随访时间为1至9年。所有患者症状均有主观缓解，且能用14F导尿管轻松导尿。尿道平均管径从9.25F增加到16.5F，排尿后残余尿量从130cc减少到15cc。1例膀胱低张患者出现尿潴留，在3个月内缓解。1例患者在初次手术后3周进行了1次重复扩张，无复发。无患者出现压力性尿失禁。无即刻或延迟的严重并发症。
女性尿道狭窄疾病是一种罕见的疾病，可导致排尿症状、反复感染、尿潴留和肾功能损害。这种手术修复方法效果持久，并发症发生率低。
