Ventral-inlay buccal mucosal graft urethroplasty for female urethral stricture

INTRODUCTION: The aim of the study is to present our initial experience with ventral-inlay buccal mucosal graft urethroplasty (VI-BMGU) in female urethral stricture disease (USD). METHODS: Between May 2016 and June 2018, 12 women with USD underwent VI-BMGU. All women were evaluated preoperatively with the American Urological Association (AUA) symptom score, uroflowmetry, calibration with a 12 Fr catheter, and ultrasonography with postvoid residual (PVR) urine measurement. Intraoperative confirmation of stricture was done with a 6 Fr cystoscope. Postoperatively, the women were followed at 3, 6, and 12 months after surgery with AUA symptom score, uroflowmetry, and PVR estimation. Increase in AUA symptom score, maximum flow rate (Q(max)) <12 ml/s, and failure to calibrate with 18 Fr catheters were considered as indicative of recurrence of the disease. RESULTS: The mean age of the patients was 41 years. The mean follow-up period was 18 months. All women voided successfully after catheter removal. There was an improvement in AUA symptom score and Q(max) and a reduction in PVR at 3, 6, and 12 months. One woman had recurrence of stricture at 6 months and was treated by urethral dilatation followed by the institution of a self-dilatation regimen. The success rate was 92% in our case series. CONCLUSIONS: VI-BMGU is a simple and safe method of urethroplasty in women. Studies with a larger sample size and a longer follow-up are required to document the long-term success of this procedure.