Waterloos Marjan, Verla Wesley, Wirtz Michel, Waterschoot Mieke, Claeys Wietse, Francois Philippe, Lumen Nicolaas
AZ Maria Middelares Gent, 9000 Ghent, Belgium.
Ghent University Hospital, 9000 Ghent, Belgium.
J Clin Med. 2021 Aug 31;10(17):3950. doi: 10.3390/jcm10173950.
Female urethral strictures and injuries are relatively uncommon compared to males. A wide range of possible causes and treatment modalities have been described. Lately female urethral reconstruction is gaining attention and is fortunately no longer a neglected topic within the reconstructive urology. As such, we aimed to describe our surgical techniques and outcomes for female urethroplasty from a tertiary center.
Records of female patients who underwent a urethroplasty between July 2018 and May 2021 in our tertiary referral center were reviewed. Patients were subdivided in two groups: patients who suffered from a urethral injury and received an early repair urethroplasty, and patients with a true urethral stricture who received a delayed urethroplasty. Preprocedural, surgical and postoperative data were collected and analyzed with descriptive statistics.
A total of five patients in group 1 and nine patients in group 2 were included. Etiology of the urethral injury in group 1 was iatrogenic in 80% and transitional cell carcinoma of the urethra in 20% of cases. A patency rate of 100% at a follow-up of 30 months was achieved with the different techniques. In group 2 etiology was idiopathic (44%), iatrogenic (44%) and due to external trauma in 12% of cases. Urethroplasty technique consisted of primary repair or dorsal onlay of a buccal mucosal graft. Patency rate was 100% at a median follow-up of 13 months. Three patients suffered from postoperative urinary incontinence, one in group 1 and two in group 2.
Female urethroplasty is a relatively rare entity within reconstructive urethral surgery. This case series of 14 patients demonstrates that with appropriate surgical techniques, a high patency rate with a low complication rate can be achieved. Further prospective studies with standardized diagnostic workup and follow-up should be performed in order to optimize management strategy.
与男性相比，女性尿道狭窄和损伤相对少见。已有多种可能的病因和治疗方式被描述。近来，女性尿道重建受到关注，幸运的是，它在重建泌尿外科领域不再是一个被忽视的话题。因此，我们旨在描述我们三级中心女性尿道成形术的手术技术和结果。
回顾了2018年7月至2021年5月在我们三级转诊中心接受尿道成形术的女性患者记录。患者分为两组：遭受尿道损伤并接受早期修复尿道成形术的患者，以及患有真性尿道狭窄并接受延迟尿道成形术的患者。收集术前、手术和术后数据，并进行描述性统计分析。
第1组共纳入5例患者，第2组共纳入9例患者。第1组尿道损伤的病因80%为医源性，20%为尿道移行细胞癌。采用不同技术在30个月随访时通畅率达到100%。第2组病因中，特发性占44%，医源性占44%，12%为外部创伤。尿道成形术技术包括一期修复或颊黏膜移植片背侧覆盖。在中位随访13个月时通畅率为100%。3例患者出现术后尿失禁，第1组1例，第2组2例。
女性尿道成形术在重建尿道手术中是一种相对罕见的情况。这个14例患者的病例系列表明，采用适当的手术技术，可以实现高通畅率和低并发症率。应进行进一步的前瞻性研究，采用标准化的诊断检查和随访，以优化管理策略。
