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Transpubic Access Using Pedicle Tubularized Labial Urethroplasty for the Treatment of Female Urethral Strictures Associated with Urethrovaginal Fistulas Secondary to Pelvic Fracture
- Source :
- European Urology. 56:193-200
- Publication Year :
- 2009
- Publisher :
- Elsevier BV, 2009.
-
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, and participants 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 3×3.5×3cm 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 1.5–3.5cm, 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 and limitations 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 13ml/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.
- Subjects :
- Adult
Stress incontinence
medicine.medical_specialty
Adolescent
Urology
Urethroplasty
medicine.medical_treatment
Anastomosis
Urethral stenosis
Surgical Flaps
Vulva
Fractures, Bone
Young Adult
Ischium
Urethra
Urethrovaginal fistula
Urethral Diseases
medicine
Humans
Postoperative Care
Urethral Stricture
Multiple Trauma
business.industry
Vaginal Fistula
Anastomosis, Surgical
Mouth Mucosa
Middle Aged
Plastic Surgery Procedures
Pelvic cavity
medicine.disease
Surgery
Cystostomy
Treatment Outcome
medicine.anatomical_structure
Labia minora
Vagina
Pelvic fracture
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 03022838
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- European Urology
- Accession number :
- edsair.doi.dedup.....74f71b4eb39c7fe83edbb8e0cdb4de5e