Dorsal vaginal graft urethroplasty for female urethral stricture disease

OBJECTIVE • To review the technique and outcomes of using a dorsal vaginal graft to perform urethroplasty for the treatment of urethral strictures in women. PATIENTS AND METHODS • This is a retrospective chart review of 11 women who were treated with a dorsal vaginal graft urethroplasty by one surgeon. • All women underwent preoperative evaluation that included history, physical examination, fl uoro-urodynamics and urethral calibration. • After surgery interviews, physical examinations, and urinary fl ow and postvoid residual urine volumes (PVRs) were obtained. RESULTS • In all, 11 women who had undergone dorsal vaginal graft urethroplasty were identified for review. The mean (range) age was 60.6 (39-75) years. The mean (range) follow-up was 22.7 (6-46) months. • There were no cases of new onset stress urinary incontinence. The mean PVRs before and after surgery were 187.1 mL and 75.8 mL, respectively ( P =0.003). The mean urinary fl ows before and after surgery were 7.3 mL/s and 21.8 mL/s, respectively ( P =0.001). • No patient has required repeat surgery. • Self-reporting satisfaction scores using the Patient Global Impression of Improvement showed that four patients scored 1 (very much better), three scored 2 (much better), two patients scored 3 (a little better), and one scored 4 (no change). Only one patient scored a 5 (worse). CONCLUSION • Dorsal graft urethroplasty with vaginal mucosa may be considered as a first-line option for definitive management of female urethral stricture disease. No consensus exists for the surgical treatment of female urethral stricture disease.