Ventral Inlay Labia Minora Graft Urethroplasty for the Management of Female Urethral Strictures

OBJECTIVE To evaluate the functional outcomes of ventral inlay labia minora graft urethroplasty (VILGU) for the management of female urethral strictures. METHODS Data of 7 consecutive women treated with VILGU between 2011 and 2013 were reviewed. Two patients had cystostomy tubes at repair, and 5 had undergone previous urethral dilations and urethrotomies. Clinical evaluation included assessment of the effect of voiding symptoms with American Urological Association (AUA) symptom score, uroflowmetry, voiding cystourethrography, and intraoperative urethrocystoscopy using a 6.5F pediatric ureterorenoscope. Preoperative AUA symptom score and peak urinary flow rate were compared with postoperative values. Cure was defined as the absence of any restenosis requiring additional intervention with subjective patient satisfaction at the last follow-up. RESULTS Mean stricture length was 1.5 cm (range, 1-2.5), and mean operative time was 95 minutes (range, 70-110). With a mean follow-up of 18.2 months (range, 3-30), cure was achieved in 6 (86%) women. At the last follow-up, mean maximum urine flow (mL/s) increased from 3.9 +/- 3.1 preoperatively to 22.7 +/- 8.3 postoperatively (P < .001), and mean AUA symptom score decreased from 25.3 +/- 5.2 preoperatively to 6.9 +/- 3.7 postoperatively (P = .001). No fistulae developed after surgery. "De-novo" stress urinary incontinence was not evident in any case. CONCLUSION VILGU effectively provides better urinary flow and significantly improves patient satisfaction in patients with female urethral stricture disease. (C) 2014 Elsevier Inc.