Skip to main content

Advertisement

SpringerLink
Log in

Quality of life is improved after urethroplasty in women with urethral stricture

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

To evaluate the quality of life (QoL) in women who underwent urethroplasty for urethral stricture.

Methods

Twenty-two women who underwent ventral labium minus graft urethroplasty were included. Patients were assessed with uroflowmetry, urethral caliber and post-voiding residual urine (PVR). American Urological Association (AUA) symptom score, Urogenital Distress Inventory (UDI)-6 and Short Form-36 (SF-36) were used to evaluate QoL. Preoperative values were compared with patients’ last visit data. The cure of the surgery was defined as a maximum flow rate > 15 ml/s in uroflowmetry and no need for any further intervention.

Results

Median age was 55 (40–66) years. Cure was achieved in 20 (90.3%) patients with median 37 (13–52) months follow-up duration. The median Qmax increased from 4 (0–5) ml/s to 27.5 (8–55) ml/s (p < 0.001). Median post-void residual volume (PVR) decreased from 52.5 (0–120) ml to 20(0–60) ml (p = 0.011). Both AUA symptom score [from median 30 (24–35) to 4.5 (0–20), p < 0.001] and AUA-QoL score [from median 5 (4–6) to 0(0–3), p < 0.001] decreased after surgery. Median UDI summary score at the last follow-up was 0 (0–44.4), which was 33.3 (22.2–61.05) at baseline visit. Improvement was observed in all domains except the ‘Energy/Fatigue’ domain of the SF-36.

Conclusions

Urethroplasty is an effective surgical method to improve patients’ QoL which is impaired because of female urethral stricture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mukhtar BMB, Spilotros M, Malde S, Greenwell TJ. Ventral-onlay buccal mucosa graft substitution urethroplasty for urethral stricture in women. BJU Int. 2017;120(5):710–6. https://doi.org/10.1111/bju.13970.

    Article  PubMed  Google Scholar 

  2. Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000;19(5):553–64. https://doi.org/10.1002/1520-6777(2000)19:5<553::aid-nau2>3.0.co;2-b.

  3. Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol. 1999;161(5):1535–40.

    Article  CAS  Google Scholar 

  4. Sarin I, Narain TA, Panwar VK, Bhadoria AS, Goldman HB, Mittal A. Deciphering the enigma of female urethral strictures: a systematic review and meta-analysis of management modalities. Neurourol Urodyn. 2021;40(1):65–79. https://doi.org/10.1002/nau.24584.

    Article  PubMed  Google Scholar 

  5. Osman NI, Chapple CR. Contemporary surgical management of female urethral stricture disease. Curr Opin Urol. 2015;25(4):341–5. https://doi.org/10.1097/MOU.0000000000000186.

    Article  PubMed  Google Scholar 

  6. Groutz A, Blaivas JG, Fait G, Sassone AM, Chaikin DC, Gordon D. The significance of the American urological association symptom index score in the evaluation of women with bladder outlet obstruction. J Urol. 2000;163(1):207–11.

    Article  CAS  Google Scholar 

  7. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenital distress inventory. Continence program for women research group. Neurourol Urodyn. 1995;14(2):131–9. https://doi.org/10.1002/nau.1930140206.

    Article  CAS  PubMed  Google Scholar 

  8. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.

    Article  Google Scholar 

  9. Onol FF, Onol SY, Tahra A, Boylu U. Ventral inlay labia minora graft urethroplasty for the management of female urethral strictures. Urology. 2014;83(2):460–4. https://doi.org/10.1016/j.urology.2013.09.020.

    Article  PubMed  Google Scholar 

  10. 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. https://doi.org/10.1007/s11934-019-0933-1.

    Article  PubMed  Google Scholar 

  11. West C, Lawrence A. Female urethroplasty: contemporary thinking. World J Urol. 2019;37(4):619–29. https://doi.org/10.1007/s00345-018-2564-4.

    Article  CAS  PubMed  Google Scholar 

  12. Ting-ting Tao Q-kX, Hu Q, Huang X-j, Chen J, Wang W-z, Lv B, Duan Y. Novel surgical technique for female distal urethral stricture disease : an evaluation of efficacy and safety compared with urethral dilatation. Int J Clin Exp Med. 2018;11(11):12002–7.

    Google Scholar 

  13. Blaivas JG, Santos JA, Tsui JF, Deibert CM, Rutman MP, Purohit RS, et al. Management of urethral stricture in women. J Urol. 2012;188(5):1778–82. https://doi.org/10.1016/j.juro.2012.07.042.

    Article  PubMed  Google Scholar 

  14. Romman AN, Alhalabi F, Zimmern PE. Distal intramural urethral pathology in women. J Urol. 2012;188(4):1218–23. https://doi.org/10.1016/j.juro.2012.06.016.

    Article  PubMed  Google Scholar 

  15. Romero-Maroto J, Verdu-Verdu L, Gomez-Perez L, Perez-Tomas C, Pacheco-Bru JJ, Lopez-Lopez A. Lateral-based anterior Vaginal Wall flap in the treatment of female urethral stricture: efficacy and safety. Eur Urol. 2018;73(1):123–8. https://doi.org/10.1016/j.eururo.2016.09.029.

    Article  PubMed  Google Scholar 

  16. Simonato A, Varca V, Esposito M, Carmignani G. Vaginal flap urethroplasty for wide female stricture disease. J Urol. 2010;184(4):1381–5. https://doi.org/10.1016/j.juro.2010.06.042.

    Article  PubMed  Google Scholar 

  17. Kowalik C, Stoffel JT, Zinman L, Vanni AJ, Buckley JC. Intermediate outcomes after female urethral reconstruction: graft vs flap. Urology. 2014;83(5):1181–5. https://doi.org/10.1016/j.urology.2013.12.052.

    Article  PubMed  Google Scholar 

  18. Gozzi C, Roosen A, Bastian PJ, Karl A, Stief C, Tritschler S. Volar onlay urethroplasty for reconstruction of female urethra in recurrent stricture disease. BJU Int. 2011;107(12):1964–6. https://doi.org/10.1111/j.1464-410X.2010.09790.x.

    Article  PubMed  Google Scholar 

  19. Goel A, Paul S, Dalela D, Sankhwar P, Sankhwar SN, Singh V. Dorsal onlay buccal mucosal graft urethroplasty in female urethral stricture disease: a single-center experience. Int Urogynecol J. 2014;25(4):525–30. https://doi.org/10.1007/s00192-013-2249-x.

    Article  PubMed  Google Scholar 

  20. Hampson LA, Myers JB, Vanni AJ, Virasoro R, Smith TG 3rd, Capiel L, et al. Dorsal buccal graft urethroplasty in female urethral stricture disease: a multi-center experience. Transl Androl Urol. 2019;8(Suppl 1):S6–S12. https://doi.org/10.21037/tau.2019.03.02.

    Article  PubMed  PubMed Central  Google Scholar 

  21. 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. https://doi.org/10.1002/nau.24507.

    Article  PubMed  Google Scholar 

  22. Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL. Conceptual model of health-related quality of life. J Nurs Scholarsh. 2005;37(4):336–42. https://doi.org/10.1111/j.1547-5069.2005.00058.x.

    Article  PubMed  Google Scholar 

  23. Onol FF, Antar B, Kose O, Erdem MR, Onol SY. Techniques and results of urethroplasty for female urethral strictures: our experience with 17 patients. Urology. 2011;77(6):1318–24. https://doi.org/10.1016/j.urology.2011.01.017.

    Article  PubMed  Google Scholar 

  24. Powell CR, Daniels D. Dorsal Onlay buccal Urethroplasty in the female is associated with high quality of life using validated lower urinary tract symptom instruments. Urology Practice. 2017;4(1):48–53. https://doi.org/10.1016/j.urpr.2016.02.002.

    Article  Google Scholar 

  25. Lane GI, Gracely A, Uberoi P, Lee U, Smith AL, Anger JT, et al. Changes in patient reported outcome measures after treatment for female urethral stricture. Neurourol Urodyn. 2021. https://doi.org/10.1002/nau.24653.

  26. Araki I, Tsuchida T, Nomura T, Fukasawa M, Takihana Y, Koyama N, et al. Differential impact of lower urinary tract symptoms on generic and disease-specific quality of life in men and women. Urol Int. 2008;81(1):60–5. https://doi.org/10.1159/000137642.

    Article  PubMed  Google Scholar 

  27. Araki I, Beppu M, Kajiwara M, Mikami Y, Zakoji H, Fukasawa M, et al. Prevalence and impact on generic quality of life of urinary incontinence in Japanese working women: assessment by ICI questionnaire and SF-36 health survey. Urology. 2005;66(1):88–93. https://doi.org/10.1016/j.urology.2005.01.059.

    Article  PubMed  Google Scholar 

  28. 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. https://doi.org/10.1007/s00345-016-1947-7.

    Article  CAS  PubMed  Google Scholar 

  29. 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. https://doi.org/10.1016/j.eururo.2013.07.038.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Ahmet Tahra

    Present address: Department of Urology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey

Authors and Affiliations

  1. Department of Urology, Health Sciences University, Umraniye Training & Research Hospital, Istanbul, Turkey

    Ahmet Tahra, Resul Sobay & Eyüp Veli Küçük

Authors
  1. Ahmet Tahra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Resul Sobay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eyüp Veli Küçük
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A Tahra: Project development, Data Collection, Data analysis, Manuscript writing/editing.

R Sobay: Data Collection, Data analysis.

EV Küçük: Project development, Manuscript writing/editing.

Corresponding author

Correspondence to Ahmet Tahra.

Ethics declarations

Conflict of interest

The authors declare they have no conflicts of interest.

Ethical approval

The study protocol (2020-No:0397) was approved by the ethics committee of our institution.

Informed consent

Informed consent was obtained from all participants who completed the survey.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tahra, A., Sobay, R. & Küçük, E.V. Quality of life is improved after urethroplasty in women with urethral stricture. Int Urogynecol J 33, 597–603 (2022). https://doi.org/10.1007/s00192-021-05026-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-021-05026-z

Keywords

Search

Navigation