The following is a summary of “Comparative analysis of dorsal onlay buccal mucosal graft and vaginal wall graft urethroplasty for female urethral stricture at a tertiary care centre,” published in the September 2024 issue of Urology by Kudunthail et al.

This study aims to compare the clinical outcomes of dorsal onlay urethroplasty using Buccal Mucosal Graft (BMG) versus Vaginal Wall Graft (VWG) in the treatment of Female Urethral Stricture (FUS). A retrospective analysis was conducted on 33 female patients who underwent dorsal onlay urethroplasty at a tertiary care center, with 17 receiving BMG and 16 undergoing VWG. Patient demographics, comorbidities, stricture characteristics, and pre-operative and post-operative Female Sexual Function Index (FSFI) scores were meticulously analyzed alongside operative outcomes. The diagnosis of urethral stricture was confirmed through a comprehensive diagnostic workup that included uroflowmetry, micturating cystourethrogram, urethral calibration, and urethrocystoscopy. 

Post-operatively, the urethral catheter was removed after three weeks, and patients were regularly followed up with urine analysis, uroflowmetry, and post-void residual urine assessments. The study population had a mean age of 47 years, ranging from 21 to 75 years, with a mean follow-up duration of 16 months (range: 6–26 months). The findings revealed no statistically significant difference between the BMG and VWG groups in key clinical parameters, including the American Urological Association (AUA) symptom score, which improved from 18 to 4; maximum flow rate (Qmax), which increased from 5 mL/s to 24 mL/s; and post-void residual urine (PVRU), which decreased from 110 mL to 10 mL. The average operative time was 97 minutes, with no significant difference between the graft types. The overall urethral patency rate was 93.9%, with both grafts demonstrating equivalent efficacy and a low complication rate. 

Notably, none of the patients developed urinary incontinence following the procedure. The study concludes that both BMG and VWG dorsal onlay substitution urethroplasty are effective and durable treatment options for FUS, offering significant therapeutic benefits and minimizing the need for repeated urethral dilatations. These findings support substituting urethroplasty as a preferred intervention for patients presenting with FUS to achieve long-term clinical success.

Source: sciencedirect.com/science/article/abs/pii/S0090429524007684