Skip to main content
SpringerLink
Log in
Book cover

Complications of Female Incontinence and Pelvic Reconstructive Surgery pp 205–219Cite as

Female Urethral Reconstructive Surgery

  • Chapter
  • First Online:

  • 895 Accesses

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Female urethral reconstruction is an uncommonly performed surgery to repair female urethral strictures, diverticulum, and fistulas. Because of the rarity of these operations, complications have not been well described in the literature. Complications can be categorized as intraoperative and postoperative. Postoperative can be further divided into general complications common to all pelvic surgery, which will not be discussed here, and those that are specific to urethral reconstruction. Those complications include: (1) early or late postoperative wound complications from the graft or flap harvest site, (2) stricture or fistula recurrence, (3) de novo postoperative incontinence, (4) de novo or recurrent urethral obstruction, and (5) de novo detrusor overactivity.

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

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Flisser AJ, Blaivas JG. Outcome of urethral reconstructive surgery in a series of 74 women. J Urol. 2003;169(6):2246–9.

    Article  PubMed  Google Scholar 

  2. Elkins TE, DeLancey JO, McGuire EJ. The use of modified Martius graft as an adjunctive technique in vesicovaginal and rectovaginal fistula repair. Obstet Gynecol. 1990;75(4):727–33.

    CAS  PubMed  Google Scholar 

  3. Gormley EA. Vaginal flap urethroplasty for female urethral stricture disease. Neurourol Urodyn. 2010;29(Suppl 1):S42–5.

    Article  PubMed  Google Scholar 

  4. Tanello M, Frego E, Simeone C, Cosciani Cunico S. Use of pedicle flap from the labia minora for the repair of female urethral strictures. Urol Int. 2002;69(2):95–8.

    Article  CAS  PubMed  Google Scholar 

  5. Blaivas JG, Purohit RS, Benedon MS, Mekel G, Stern M, Billah M, et al. Safety considerations for synthetic sling surgery. Nat Rev Urol. 2015;12(9):481–509.

    Article  PubMed  Google Scholar 

  6. Amundsen CL, Flynn BJ, Webster GD. Urethral erosion after synthetic and nonsynthetic pubovaginal slings: differences in management and continence outcome. J Urol. 2003;170(1):134–7; discussion 7.

    Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. Tsivian A, Sidi AA. Dorsal graft urethroplasty for female urethral stricture. J Urol 2006;176(2):611–3; discussion 3.

    Google Scholar 

  10. Migliari R, Leone P, Berdondini E, De Angelis M, Barbagli G, Palminteri E. Dorsal buccal mucosa graft urethroplasty for female urethral strictures. J Urol. 2006;176(4 Pt 1):1473–6.

    Article  PubMed  Google Scholar 

  11. Rehder P, Glodny B, Pichler R, Exeli L, Kerschbaumer A, Mitterberger MJ. Dorsal urethroplasty with labia minora skin graft for female urethral strictures. BJU Int. 2010;106(8):1211–4.

    Article  PubMed  Google Scholar 

  12. Montorsi F, Salonia A, Centemero A, Guazzoni G, Nava L, Da Pozzo LF, et al. Vestibular flap urethroplasty for strictures of the female urethra. Impact on symptoms and flow patterns. Urol Int. 2002;69(1):12–6.

    Article  PubMed  Google Scholar 

  13. O’Connell HE, DeLancey JO. Clitoral anatomy in nulliparous, healthy, premenopausal volunteers using unenhanced magnetic resonance imaging. J Urol. 2005;173(6):2060–3.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Park JM, Hendren WH. Construction of female urethra using buccal mucosa graft. J Urol. 2001;166(2):640–3.

    Article  CAS  PubMed  Google Scholar 

  15. Berglund RK, Vasavada S, Angermeier K, Rackley R. Buccal mucosa graft urethroplasty for recurrent stricture of female urethra. Urology. 2006;67(5):1069–71.

    Article  PubMed  Google Scholar 

  16. Bhargava S, Chapple CR. Buccal mucosal urethroplasty: is it the new gold standard? BJU Int. 2004;93(9):1191–3.

    Article  CAS  PubMed  Google Scholar 

  17. Souza GF, Calado AA, Delcelo R, Ortiz V, Macedo Jr A. Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits. Int Braz J Urol. 2008;34(3):345–51; discussion 51–4.

    Google Scholar 

  18. Dublin N, Stewart LH. Oral complications after buccal mucosal graft harvest for urethroplasty. BJU Int. 2004;94(6):867–9.

    Article  PubMed  Google Scholar 

  19. Kamp S, Knoll T, Osman M, Hacker A, Michel MS, Alken P. Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek? BJU Int. 2005;96(4):619–23.

    Article  PubMed  Google Scholar 

  20. Wong E, Fernando A, Alhasso A, Stewart L. Does closure of the buccal mucosal graft bed matter? Results from a randomized controlled trial. Urology. 2014;84(5):1223–7.

    Article  PubMed  Google Scholar 

  21. Sharma GK, Pandey A, Bansal H, Swain S, Das SK, Trivedi S, et al. Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women. BJU Int. 2010;105(9):1309–12.

    Article  PubMed  Google Scholar 

  22. Simonato A, Gregori A, Lissiani A, Galli S, Ottaviani F, Rossi R, et al. The tongue as an alternative donor site for graft urethroplasty: a pilot study. J Urol. 2006;175(2):589–92.

    Article  PubMed  Google Scholar 

  23. Elkins TE, Ghosh TS, Tagoe GA, Stocker R. Transvaginal mobilization and utilization of the anterior bladder wall to repair vesicovaginal fistulas involving the urethra. Obstet Gynecol. 1992;79(3):455–60.

    Article  CAS  PubMed  Google Scholar 

  24. Blaivas JG, Sandhu J. Urethral reconstruction after erosion of slings in women. Curr Opin Urol. 2004;14(6):335–8.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. Clemens JQ, DeLancey JO, Faerber GJ, Westney OL, McGuire EJ. Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology. 2000;56(4):589–94.

    Article  CAS  PubMed  Google Scholar 

  27. Blaivas JG, Heritz DM. Vaginal flap reconstruction of the urethra and vesical neck in women: a report of 49 cases. J Urol. 1996;155(3):1014–7.

    Article  CAS  PubMed  Google Scholar 

  28. Petrou SP, Jones J, Parra RO. Martius flap harvest site: patient self-perception. J Urol. 2002;167(5):2098–9.

    Article  PubMed  Google Scholar 

  29. Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183(5):1906–14.

    Article  PubMed  Google Scholar 

  30. Blaivas JG, Chaikin DC. Pubovaginal fascial sling for the treatment of all types of stress urinary incontinence: surgical technique and long-term outcome. Urol Clin North Am. 2011;38(1):7–15, v.

    Google Scholar 

Download references

Acknowledgment

The authors gratefully acknowledge the contribution of Dorota (Borawski) Witulska, M.D., who coauthored the prior edition of this chapter.

Author information

Authors and Affiliations

  1. Department of Urology, Weill Medical College of Cornell University, 445 East 77th Street, New York, NY, 10075, USA

    Rajveer S. Purohit M.D., M.P.H. & Jerry G. Blaivas M.D.

Authors
  1. Rajveer S. Purohit M.D., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jerry G. Blaivas M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rajveer S. Purohit M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Glickman Urology & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Howard B. Goldman

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Purohit, R.S., Blaivas, J.G. (2017). Female Urethral Reconstructive Surgery. In: Goldman, H. (eds) Complications of Female Incontinence and Pelvic Reconstructive Surgery. Current Clinical Urology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-49855-3_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-49855-3_19

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-49854-6

  • Online ISBN: 978-3-319-49855-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation