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Female Urethral Stricture

Urethra Stricture female


Presentation

  • PURPOSE: To report the etiology, presenting symptoms and outcomes of the different treatments performed in female patients with recurrent urethral stricture.[ncbi.nlm.nih.gov]
  • To present a novel modification of surgical technique to treat female urethral stricture (FUS) by a vaginal-sparing ventral buccal mucosal urethroplasty.[ncbi.nlm.nih.gov]
  • No strict criteria for diagnosis have been established with the diagnosis often relying on a combination of presenting symptoms and objective findings.[ncbi.nlm.nih.gov]
  • Almost all 16 patients presented with poor flow and feeling of incomplete voiding, two of them had recurrent urinary tract infections and two had frequency and urgency as their main presenting complaints.[indianjurol.com]
  • Materials and Method s : We report a case of 35-years-female who was presented to us with total mid-urethral stricture with false passage following multiple urethral dilatation attempts.[jstcr.org]
Recurrent Urinary Tract Infection
  • MATERIALS AND METHODS: Three 60-year-old females, each with a history of recurrent urinary tract infections and obstructive voiding symptoms due to urethral stricture, underwent urethroplasty with a dorsal vaginal or buccal mucosal graft.[ncbi.nlm.nih.gov]
  • Hallmark symptoms are frequency and urgency, and may also be dysuria, hesitancy, slow stream, incontinence, and recurrent urinary tract infections.[ncbi.nlm.nih.gov]
  • As in males, urethral stricture disease in females can cause voiding and storage lower urinary tract symptoms, recurrent urinary tract infections, and even renal impairment.[indianjurol.com]
  • urinary tract infections increasing amount of urine left in bladder after urination failure of medication to control your pain A number of surgical procedures are available for treating urethral strictures.[beaumont.org]
  • Symptoms of the urethral stricture can include pain with urination and incomplete bladder emptying, recurrent urinary tract infections, urinary incontinence, the need to urinate frequent at night and many severe cases can result in kidney failure and[northaustinurology.com]
Wound Infection
  • Patients did not report any significant postoperative pain or discharge suggestive of wound infection and were advised to return to their normal daily activities after 3 to 4 days.[indianjurol.com]
Suggestibility
  • In other words, the category extended from urethral irritability to signs and symptoms suggesting pronounced renal lesions. This undoubtedly has also been the experience of many urologists, as I have learned from my consultations and correspondence.[jamanetwork.com]
  • My uro is suggesting urethroplasty surgery for me. I need to connect with other women who have gone through this..Please..if you are female, and have had this surgery, please contact me...[healthboards.com]
  • ., [6] have even suggested primary repair of the urethra with simple urethral realignment over a catheter, as the procedure of choice for female urethral injury associated with a pelvic fracture.[jstcr.org]
  • There is no evidence to suggest that this intervention works and many cases of true urethral stricture are likely a result of these unnecessary dilations.[news-medical.net]
  • At present, there are no defined diagnostic criteria for female urethral stricture; however, lower urinary tract symptoms and difficulty in placing a 12 Fr urethral catheter or larger is suggestive [7].[urotoday.com]
Fear
  • I'm fearful of being left incontinent. Anybody out there who can tell me the success rates? Anyone who would recommend going through with it? I'd be forever grateful for any help. Cheers, M 1 like, 10 replies[gopatients.info]
  • When anastomotic urethroplasty is planned in such a patient, there is fear of anastomosis of distal urethra to proximal false lumen instead of the normal anatomical lumen. [1] Anastomosis to false lumen can further give rise to complications like failed[jstcr.org]
Dysuria
  • Hallmark symptoms are frequency and urgency, and may also be dysuria, hesitancy, slow stream, incontinence, and recurrent urinary tract infections.[ncbi.nlm.nih.gov]
  • In girls, the minimal width of the urethra can be approximated using the following formula: Urethral width [Charriere] age 10 Signs and Symptoms Dysuria, urgency and recurrent infections.[urology-textbook.com]
  • Symptoms Bloody or dark urine Decreased urine output Difficulty urinating Discharge from the urethra Frequent or urgent urination Inability to urinate (urinary retention) Incontinence Painful urination (dysuria) Pain in the lower abdomen Pelvic pain Slow[wexnermedical.osu.edu]
  • The most common symptoms of urethral strictures are : difficulty passing urine (voiding) – hesitance, straining and sometimes pain ( dysuria ) urinary retention due to incomplete emptying of the bladder repeated urinary tract infections ( UTIs – urethritis[healthhype.com]
  • The full pathognomonic triad of dysuria, dyspareunia, and post-void dribbling was noted in only four patients. 1 2 3 4 5 6 7 8 Age (years) 26 57 46 46 26 54 54 31 BMI (kg/m 2 ) 18 21 19 25 19 33 25 26 Symptoms Dysuria - - - - - - Post-void dribbling -[omicsonline.org]
Bladder Neck Obstruction
  • Bladder neck obstruction in women: a real entity. J Urol 1984; 132: 294-298 11) Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol 1999; 161: 1535-1540 12) Groutz A, Blaivas JG, Chaikin DC.[minds.jcqhc.or.jp]
  • Associated complications are urinary sepsis, phlegmon, urethrocutaneous fistula, calculosis, bladder neck obstruction, septicemia, renal failure, and occasionally malignancy. [8] Diagnosis is made by ascending urethrography, cystoscopy or micturating[mjdrdypu.org]
Bladder Neck Obstruction
  • Bladder neck obstruction in women: a real entity. J Urol 1984; 132: 294-298 11) Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol 1999; 161: 1535-1540 12) Groutz A, Blaivas JG, Chaikin DC.[minds.jcqhc.or.jp]
  • Associated complications are urinary sepsis, phlegmon, urethrocutaneous fistula, calculosis, bladder neck obstruction, septicemia, renal failure, and occasionally malignancy. [8] Diagnosis is made by ascending urethrography, cystoscopy or micturating[mjdrdypu.org]
Overflow Incontinence
  • Recurrent urinary infection Retention or inability to pass urine Incontinence of urine after retention (Overflow Incontinence) Pus discharge from urethral meatus Abscess formation in Perineal region followed by urine discharge from the abscess (urethra-cutaneous[scihospital.com]
Urethral Disease
  • The most common etiologies of female urethral stricture are traumatic urethral injury, iatrogenic urethral injury, and inflammatory urethral disease; its optimal management is still under evaluation [4].[urotoday.com]

Treatment

  • PURPOSE: To report the etiology, presenting symptoms and outcomes of the different treatments performed in female patients with recurrent urethral stricture.[ncbi.nlm.nih.gov]
  • PURPOSE OF REVIEW: Female urethral stricture disease is increasingly recognized as an uncommon but important cause of lower urinary tract symptoms in women, which is amenable to surgical treatment.[ncbi.nlm.nih.gov]
  • RESULTS: No additional treatment was required during the 1, 8 and 27 months of followup. All patients had normal micturition following catheter removal.[ncbi.nlm.nih.gov]
  • No consensus exists for the surgical treatment of female urethral stricture disease. 2012 BJU INTERNATIONAL.[ncbi.nlm.nih.gov]
  • Treatment options are conservative management with dilatation, endoscopic treatment, or open repair with various tissue flaps or grafts. Considerable controversy surrounds the efficacy of urethral dilatation in women with voiding dysfunction.[ncbi.nlm.nih.gov]

Prognosis

  • […] and even urinary incontinence A treatment of Urethral Stricture in Women may involve cystoscopy, surgical procedures, such as urethroplasty, and the placement of a catheter (if required) Urethral Stricture in Women can be treated completely and the prognosis[dovemed.com]
  • The overall prognosis for urethral stricture is good. What is the urethra? The urethra is a hollow tube that allows urine to leave the bladder.[rxlist.com]

Etiology

  • PURPOSE: To report the etiology, presenting symptoms and outcomes of the different treatments performed in female patients with recurrent urethral stricture.[ncbi.nlm.nih.gov]
  • Suspected etiology was iatrogenic from cystoscopy 17 years prior. Since then, the patient had undergone at least 25 formal urethral dilations and periods of self-dilation.[ncbi.nlm.nih.gov]
  • The most common etiologies are traumatic injury, iatrogenic injury, and inflammatory disease resulting in periurethral fibrosis.[ncbi.nlm.nih.gov]
  • The possible etiologies may be infection, prior dilation, difficult catheterization with subsequent fibrosis, urethral surgery, trauma, or idiopathic.[scienceopen.com]
  • At first, it is important to rule out a primary or direct extension malignancy etiology for the stricture.[aibolita.com]

Epidemiology

  • "SIU/ICUD consultation on urethral strictures: epidemiology, etiology, anatomy, and nomenclature of urethral stenosis, strictures, and pelvic fracture urethral disruption injuries." Urology 83 (2014): S1-7. Lumen, Nicolaas, et al.[rxlist.com]
  • The Panel suggests the following issues in future investigations: Both basic science and epidemiological research into the etiology of urethral strictures.[auanet.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiological significance of an urethral narrowing without urinary retention is controversial. Diagnostic Work-Up Cystoscopy and calibration of the urethra with Bougie a boule to determine the width of the urethra.[urology-textbook.com]

Prevention

  • Some advocate clean intermittent catheterization after urethrotomy to help prolong or “prevent” that risk of stricture recurrence.[aibolita.com]
  • A dorsal approach may also facilitate later anti-incontinence procedures, prevent sacculation of the reconstructed urethra, and minimize risk of urethrovaginal fistula or hypospadias [ 18 ].[obgynkey.com]
  • The following measures may be considered to avoid or prevent Urethral Stricture in Women: Practicing safer sex methods, which can help prevent urethral strictures caused by sexually-transmitted diseases Quick and immediate medical attention can help prevent[dovemed.com]
  • […] normal anatomical lumen. [1] Anastomosis to false lumen can further give rise to complications like failed urethroplasty and urinary incontinence that can increase morbidity as well as the cost of treatment. [1], [2] We present a point of technique to prevent[jstcr.org]
  • Urethral Stricture Topics Diagnosis of Urethral Stricture Early detection is recommended to prevent serious kidney problems.[brighamandwomens.org]

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