“OUTCOMES OF DORSAL ONLAY URETHROPLASTY USING BUCCAL AND VAGINAL GRAFTS FOR FEMALE URETHRAL STRICURES AT A TERTIARY HOSPITAL”
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Keywords
Female urethral stricture, Dorsal onlay urethroplasty, Buccal mucosal graft, Vaginal wall graft, Urethral reconstruction, Functional outcomes, Complications, Patient satisfa
Abstract
Background: Urethral stricture is a clinical complication that is rather uncommon in females but may result in urinary retention, repeated infections, and poor quality of life. Graft-based dorsal onlay urethroplasty with buccal mucosal grafts (BMG) or vaginal wall grafts (VWG) is a successful reconstructive method that has limited information on Pakistani tertiary care centers.
Objective: To compare the functional and anatomical outcomes, complication rates, and patient satisfaction after dorsal onlay urethroplasty with buccal and vaginal grafts in women with Urethral strictures.
Methods: The study was a cross-sectional study conducted at Department of Urology, Pakistan Institute of Medical Sciences Islamabad in the duration from January, 2025 to June, 2025. Forty adult females who had symptomatic urethral strictures were undergoing dorsal onlay urethroplasty using BMG (n=22) or VWG (n=18). The preoperative evaluation comprised uroflowmetry, post-void residual, urethroscopy, and imaging. Urinary flow, graft success, complications, and patient satisfaction were measured in postoperative follow-up at 1, 3, and 6 months.
Results: Mean patient age was 42.5 ± 12.3 years. Uroflowmetry improved significantly, with a postoperative mean stricture length of 1.8 ± 0.6 cm. Qmax improved significantly preoperatively, 7.2±1.9 mL/s vs. postoperatively 19.6 ±3.2 mL/s (p < 0.001). BMG and VWG had an overall success rate of 90.9% and 88.9%, respectively. Fifteen percent of patients recorded minor complications, and no significant complications. The rate of high patient satisfaction was found in 87.5 percent of cases.
Conclusion: Buccal or vaginal graft dorsal onlay urethroplasty is a safe and efficient method of treating female urethral strictures, offering superior functional results, few complications, and high patient satisfaction. The choice of grafts can be customized by the availability of tissues and the preference of the patient, and the success of this working process requires attention to surgical methods.
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Dr Mohib Ullah
Postgraduate Resident, Department of Urology, Pakistan Institute of Medical Sciences Islamabad
Dr Haroon Khalid
Registrar, Department of Urology, University Hospital Waterford
Dr Aftab Ahmed
Assistant Professor, Department of Urology, Shiek Khalifa bin Zaid/ CMH Hospital Muzaffarabad AJK
Dr Shakeel Haseeb Uddin Siddique
Assistant Professor of Urology, Hamdard University, Karachi
Dr Muhammad Akhtar
Associate Professor, Department of Urology, Ibn e Sina Hospital and Research Institute, Multan/ Multan Medical and Dental College Multan
Dr Adnan Siddiq Awan
Specialist Urologist, Sabah Al Ahmad Urology Center, Kuwait
