Female urethral stricture: an underdiagnosed condition
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v83i4.998Keywords:
Urethral stricture, urethral pathology, female urethral anatomy, urethral diverticulum, urethral stricture diagnosis, urethral dilatationAbstract
Introduction: Urethral stricture is defined as a fixed, symptomatic anatomical narrowing of the urinary canal, that do not adapt to urethral instrumentation, however, in the case of women it is a controversial pathology and is frequently not diagnosed, which leads to an inadequate selection of treatment.
Objective and methodology: There are few studies that show clear diagnostic parameters and a prevalence with a wide range, in addition to a low bibliographic resource, for which reason this project will review the definition, anatomy, etiology, clinical manifestations, diagnosis, and treatment of this pathology in the female population.
Conclusions: It is important to know both the anatomy of the female urethra and the possible etiologies of urethral stenosis in order to get closer to the diagnosis and offer the appropriate treatment in each case, depending on the patient's symptoms.
References
Gómez V, Hernández V, Capitan C, Carrera C, Sánchez M, De la Peña E, et al. Urethral stricture in women. Morphofunctional diagnosis and treatment. Arch Esp Urol. 2011 Mar;64(2):97–104.
Audouin M, Sèbe P. Uretra femenina normal y patológica. EMC - Urología. 2014 Jun;46(2):1–13. doi: https://doi.org/10.1016/s1761-3310(14)67534-4
Karam I, Droupy S, Abd-Alsamad I, Uhl J-F, Benoît G, Delmas V. Innervation of the Female Human Urethral Sphincter: 3D Reconstruction of Immunohistochemical Studies in the Fetus. European Urology. 2005 May;47(5):627–34. doi: https://doi.org/10.1016/j.eururo.2005.01.001
Montorsi F, Salonia A, Centemero A, Guazzoni G, Nava L, Da Pozzo LF, et al. Vestibular Flap Urethroplasty for Strictures of the Female Urethra. Urol Int. 2002;69(1):12–6. doi: https://doi.org/10.1159/000064353
Thind P. The significance of smooth and striated muscles in the sphincter function of the urethra in healthy women. Neurourol Urodyn. 1995;14(6):585–618. doi: https://doi.org/10.1002/nau.1930140602
Stein TA, DeLancey JOL. Structure of the Perineal Membrane in Females: Gross and Microscopic Anatomy. Obstetrics & Gynecology. 2008;111(3):686–93. doi: https://doi.org/10.1097/aog.0b013e318163a9a5
Gutiérrez Ruiz C, Rodríguez-Escovar F, Errando Smet C, Arañó Bertrán P, Villavicencio Mavrich H. Estenosis uretral en la mujer: Etiología, diagnóstico y tratamiento. Actas Urológicas Españolas. 2009;33(7):794–800. doi: https://doi.org/10.1016/S0210-4806(09)74232-9
Berglund RK, Vasavada S, Angermeier K, Rackley R. Buccal mucosa graft urethroplasty for recurrent stricture of female urethra. Urology. 2006;67(5):1069–71. doi: 10.1016/j.urology.2005.12.010
Palou J, Caparros J, Vicente J. Use of proximal-based vaginal flap in stricture of the female urethra. Urology. 1996;47(5):747–9. doi: https://doi.org/10.1016/s0090-4295(96)00031-3
Tanello M, Frego E, Simeone C, Cosciani Cunico S. Use of Pedicle Flap from the Labia minora for the Repair of Female Urethral Strictures. Urol Int. 2002;69(2):95–8. doi: https://doi.org/10.1159/000065554
Blaivas JG, Sandhu J. Urethral reconstruction after erosion of slings in women: Current Opinion in Urology. 2004;14(6):335–8. doi: https://doi.org/10.1097/00042307-200411000-00007
Flisser AJ, Blaivas JG. Outcome of Urethral Reconstructive Surgery in a Series of 74 Women. Journal of Urology. 2003;169(6):2246–9. doi: https://doi.org/10.1097/01.ju.0000061763.88247.16
Blanco Díez A, Álvarez Castelo L, Fernández Rosado E, Sánchez Rodríguez-Losada J, Chantada Abal V, Novas Castro S, et al. Rotura traumática de uretra femenina: una rara entidad. Aportación de dos casos. Actas Urológicas Españolas. 2004;28(4):318–23.
Smith AL, Ferlise VJ, Rovner ES. Female urethral strictures: successful management with long-term clean intermittent catheterization after urethral dilatation. BJU Int. 2006;98(1):96–9. doi: https://doi.org/10.1111/j.1464-410x.2006.06206.x
Spilotros M, Malde S, Solomon E, Grewal M, Mukhtar BM, Pakzad M, et al. Female urethral stricture: a contemporary series. World J Urol. 2017;35(6):991–5. doi: https://doi.org/10.1007/s00345-016-1947-7
Agochukwu-Mmonu N, Srirangapatanam S, Cohen A, Breyer B. Female Urethral Strictures: Review of Diagnosis, Etiology, and Management. Curr Urol Rep. 2019;20(11):74. doi: https://doi.org/10.1007/s11934-019-0933-1
Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol. 1999;161(5):1535–40.
Aldamanhori R, Inman R. The treatment of complex female urethral pathology. Asian J Urol. 2018;5(3):160–3. doi: https://doi.org/10.1016/j.ajur.2018.03.003
Migliari R, Leone P, Berdondini E, De Angelis M, Barbagli G, Palminteri E. Dorsal buccal mucosa graft urethroplasty for female urethral strictures. J Urol. 2006;176(4 Pt 1):1473–6. doi: https://doi.org/10.1016/j.juro.2006.06.043
Schwender CEB, Ng L, McGuire E, Gormley EA. Technique and Results of Urethroplasty for Female Stricture Disease. Journal of Urology. 2006;175(3):976–80. doi: https://doi.org/10.1016/s0022-5347(05)00336-8
Rehder P, Glodny B, Pichler R, Exeli L, Kerschbaumer A, Mitterberger MJ. Dorsal urethroplasty with labia minora skin graft for female urethral strictures. BJU International. 2010;106(8):1211–4. doi: https://doi.org/10.1111/j.1464-410x.2010.09240.x
Blaivas JG, Santos JA, Tsui JF, Deibert CM, Rutman MP, Purohit RS, et al. Management of Urethral Stricture in Women. Journal of Urology. 2012;188(5):1778–82. doi: https://doi.org/10.1016/j.juro.2012.07.042
Osman NI, Mangera A, Chapple CR. A systematic review of surgical techniques used in the treatment of female urethral stricture. Eur Urol. 2013;64(6):965–73. doi: https://doi.org/10.1016/j.eururo.2013.07.038
Sharma GK, Pandey A, Bansal H, Swain S, Das SK, Trivedi S, et al. Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women. BJU Int. 2010;105(9):1309–12. doi: https://doi.org/10.1111/j.1464-410x.2009.08951.x
Lane GI, Smith AL, Stambakio H, Lin G, Al Hussein Alawamlh O, Anger JT, et al. Treatment of urethral stricture disease in women: A multi-institutional collaborative project from the SUFU research network. Neurourol Urodyn. 2020;39(8):2433–41. doi: https://doi.org/10.1002/nau.24507
Chua KJ, Mikhail M, Patel HV, Tabakin AL, Doppalapudi SK, Sterling J, et al. Treatment of Urethral Stricture Disease in Women: Nonsystematic Review of Surgical Techniques and Intraoperative Considerations. Res Rep Urol. 2021;13:381–406. doi: https://doi.org/10.2147/rru.s282651
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