Transpubic access using pedicle tubularized labial urethroplasty for the treatment of female urethral strictures associated with urethrovaginal fistulas secondary to pelvic fracture.
Eur Urol
; 56(1): 193-200, 2009 Jul.
Article
en En
| MEDLINE
| ID: mdl-18468778
ABSTRACT
BACKGROUND:
Female urethral injury is rare, and there is no accepted standard approach for the repair of urethral strictures.OBJECTIVE:
To evaluate the efficacy of transpubic access using pedicle tubularized labial urethroplasty for urethral reconstruction in female patients with urethral obliterative strictures and urethrovaginal fistulas. DESIGN, SETTING, ANDPARTICIPANTS:
Between January 1996 and December 2006, eight cases of female urethral strictures associated with urethrovaginal fistulas were treated using pedicle labial skin flaps.INTERVENTIONS:
A flap of approximately 3x3.5x3cm of the labia minora or majora with its vascular pedicle was tubularized over an 18-22 Fr fenestrated silicone stent to create a neourethra. This technique was used in five women. Two flaps, approximately 1.5-3.5 cm, were taken from bilateral labia minora or majora and were pieced together to create a neourethra. This technique was used in three patients. MEASUREMENTS We performed voiding cystourethrography and uroflowmetry to assess postoperative results. RESULTS ANDLIMITATIONS:
The patients were followed up for 10-118 mo (mean 48.25 mo) after the procedure. There were no postoperative complications. Two patients complained of dysuria, which resolved spontaneously after 2 wk. One patient experienced stress incontinence that resolved after 4 wk. At 3-mo follow-up, one patient complained of difficulty voiding; the urinary peak flow was 13 ml/s, and the patient was treated successfully with urethral dilation. All other patients had normal micturition following catheter removal.CONCLUSIONS:
Pedicle labial urethroplasty is a reliable technique for the repair of extensive urethral damage, and a transpubic surgical approach provides wide and excellent exposure for the management of complex obliterative urethral strictures and urethrovaginal fistulas secondary to pelvic fracture.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estrechez Uretral
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Traumatismo Múltiple
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Fístula Vaginal
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Fracturas Óseas
/
Isquion
Tipo de estudio:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Eur Urol
Año:
2009
Tipo del documento:
Article