EURURO Vol. 73 No. 1

123 148

Surgery in Motion
Lateral-based Anterior Vaginal Wall Flap in the Treatment of
Female Urethral Stricture: Efficacy and Safety
Jesu´s Romero-Maroto, Lidia Verdu´-Verdu´, Luis Go´mez-Pe´rez Carla Pe´rez-Toma´s,
Juan-Jose´ Pacheco-Bru, Ana Lo´pez-Lo´pez
Department of Urology, Hospital Universitario San Juan de Alicante, Alicante, Spain
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Article info
Article history:
Accepted September 15, 2016
Associate Editor:
Alexandre Mottrie
Keywords:
Female urethral stricture
Vaginal wall flap urethroplasty:
Augmentation urethroplasty
Lower urinary tract symptoms
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Abstract
Background: Female urethral stricture is a rare condition. Different types of urethro-
plasty have been described. However, high quality studies are sparse. The most common
technique used—the Blandy’s technique—has resulted in our cases in a retrusive meatus
and an inward urinary stream.
Objective: To show the efficacy and safety of an alternative vaginal wall flap urethro-
plasty.
Design, setting, and participants: A cross-sectional observational study was undertaken
in a single University Hospital. Nine female patients previously diagnosed with urethral
stricture at our institution underwent open surgery from 1993 to 2015. They were
contacted and agreed to undergo a medical examination.
Surgical procedure: A ventral lateral-based anterior vaginal wall flap urethroplasty
inspired by the Orandi technique for male urethroplasty was performed.
Measurements: A chart review was performed.
Results and limitations: The mean age was 56 yr (41–78 yr). The mean follow-up was
80.7 mo (12–198). All patients had relief of symptoms. The meatus of all patients stayed
in an orthotopic position without any impact on the direction of the urinary stream. The
average caliber of the urethra increased from 10.8 Fr (6–18 Fr) to 20 Fr. Peak flow
improved from a mean of 6.8 ml/s (3–11 ml/s) to 21 ml/s (14–35 ml/s). No patient
developed stricture recurrence or de novo stress urinary incontinence. There were no
other immediate or delayed complications. All patients achieved a better score on the
Patient Global Impression of Improvement questionnaire.
Conclusions: Our study, with the same limitations that the few studies published in this
field had, that is the few patients included, demonstrates that lateral anterior vaginal
wall flap urethroplasty is an effective technique, offering durable results without
apparent complications.
Patient summary: We studied an alternative surgical technique for the treatment of
female urethral stricture. We conclude that it is safe and effective with no apparent
complications and good long-term results.
# 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.
* Corresponding author. Avenue General Marva 26, 28, Alicante 03004, Spain. Tel. +34 676493126;
Fax: +34 965938652.
E-mail address: (L. Go´mez-Pe´rez).
0302-2838/# 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.