Dorsal onlay Oral mucosa graft urethroplasty safe treatment of female urethral stricture: Study
Dorsal onlay oral mucosa graft urethroplasty for female urethral stricture appears feasible across multiple surgeons and is associated with a low perioperative morbidity
UP: Claire Richard and colleagues demonstrated in a recent study that dorsal onlay buccal mucosal graft urethroplasty (DBMGU) for female urethral stricture is possible across various surgeons and is linked with low perioperative morbidity, good functional results, and a low recurrence rate.
The purpose of this study was to describe and evaluate the results of dorsal onlay oral mucosa transplant urethroplasty for female urethral stricture.
The findings of this study were published in the International Urogynecology Journal on 16th September 2021.
For this purpose, the researchers examined the records of all female patients who received dorsal onlay oral (buccal or lingual) mucosa urethroplasty for urethral stricture at two academic institutions between 2011 and 2020. Clinical success was defined as any subjective improvement in LUTS self-assessed by patients 1-3 months following catheter removal. Four surgeons used a uniform approach to conduct the urethroplasties: suprameatal incision, dissection and longitudinal opening of the dorsal side of the urethra, the harvest of the oral mucosa graft, and graft onlay sutured into the urethral hole.
There were 19 patients in all. At 1-3 months, the clinical success rate was 94.7%, and at one year, it was 90.9%. There was one recurrence (5.3%) after a median follow-up of 12 months (range 1-49), clinical success was obtained in 17 patients (89.5%), and both the maximal urine flow rate and post-void residual were considerably improved. At 1-3 months, the rate of de novo stress urine incontinence was 15.7%, and at 1 year, it was 9.1%
In conclusion, the study found that Dorsal onlay oral mucosa transplant urethroplasty produced favorable outcomes in females, but bigger sample sizes and longer follow-up are required to validate these findings.
The limitations of the study include the small number of cases with short follow-up.
Reference:
Richard, C., Peyronnet, B., Drain, A., Rosenblum, N., Hascoet, J., Sussman, R. D., Freton, L., Zhao, L. C., Nitti, V. W., & Brucker, B. M. (2021). Dorsal Onlay Oral Mucosa Graft Urethroplasty for Female Urethral Stricture. In Urology. Elsevier BV. https://doi.org/10.1016/j.urology.2021.09.001
