K M Arifur Rahman, Tasnim Alam Manzer, Nahid Rahman Zico, A F M Muntahi Reza, M M Hasnat Parvez, A S M Badruddoza, Md Ashraful Islam
Female urethral stricture (FUS) yet one that can cause significant bothersome lower urinary tract symptoms (LUTS) represents an uncommon condition. A variety of reconstructive surgical techniques have been described in recent years to provide more definitive in this challenging group. Aim of the study: The aim of this study was to find out the outcome of dorsal and ventral onlay buccal mucosa graft (BMG) urethroplasty in female urethral stricture disease. Methods: This Quasi experimental study was conducted in the Department of Urology, Dhaka Medical College Hospital Dhaka during the period from July, 2018 to June, 2020. Total 30 patients with moderate to severe bothersome LUTS due to mid and/or distal urethral stricture were included in the study as per inclusion and exclusion criteria. Patients were divided into two groups. Group-A for dorsal onlay and Group-B for ventral onlay buccal mucosa graft urethroplasty to every alternate sequence. All women were evaluated preoperatively, as per predefined criteria. As failure of the treatment, increase in AUA symptom score, maximum flow rate (Qmax) <12 ml/s, and failure to calibrate with 18 Fr catheter needs subsequent intervention were considered. Results: The mean age of the patients in Group-A was 45.86 (range, 25-58) years and Group-B was 48.26 (range, 38-60) years. Majority of the women 16(53.33%) had strictures located combined at mid and distal urethra. There were significant improvements in AUA symptom score and maximum urinary flow rate (Qmax) and reduction in post void residue (PVR) (p<0.001) at 1, 3 and 6 months follow-up in both groups. In Group-B, postoperative complication rate was 53.3% and none of the patient in Group-A developed any postoperative complication (p= 0.002). In Group-A, 13(86.67%) women and in Group-B 12 (80%) women voided successfully after removal of catheter. Conclusion: Both dorsal and ventral onlay buccal mucosa graft urethroplasty in the treatment of female urethral stricture provides significant improvement in patient symptoms and urinary flow but postoperative complications are higher in ventral onlay technique.
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