Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women.
OBJECTIVE
To describe the technique and results of dorsal onlay lingual mucosal graft (LMG) urethroplasty for the definitive management of urethral strictures in women.


METHODS
In all, 15 women (mean age 42 years) with a history suggestive of urethral stricture who had undergone multiple urethral dilatations and/or urethrotomy were selected for dorsal onlay LMG urethroplasty after thorough evaluation, from October 2006 to March 2008. After a suprameatal inverted-U incision, the dorsal aspect of the urethra was dissected and urethrotomy was done at the 12 o'clock position across the strictured segment. Tailored LMG harvested from the ventrolateral aspect of the tongue was then sutured to the urethrotomy wound over an 18 F silicone catheter.


RESULTS
The preoperative mean maximum urinary flow rate of 7.2 mL/s increased to 29.87 mL/s, 26.95 mL/s and 26.86 mL/s with a 'normal' flow rate curve at 3, 6 and 12 months follow-up, respectively. One patient at the 3-month follow-up had submeatal stenosis and required urethral dilatation thrice at monthly intervals. At the 1-year follow-up, none of the present patients had any neurosensory complications, urinary incontinence, or long-term functional/aesthetic complication at the donor site.


CONCLUSIONS
LMG urethroplasty using the dorsal onlay technique should be offered for correction of persistent female urethral stricture as it provides a simple, safe and effective approach with durable results.
Sharma
Girish K
GK
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. drgirishuro@yahoo.com <drgirishuro@yahoo.com>
Pandey
Ashwani
A
Bansal
Harbans
H
Swain
Sameer
S
Das
Suren K
SK
Trivedi
Sameer
S
Dwivedi
Udai S
US
Singh
Pratap B
PB
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D055502:Secondary Prevention; D014059:Tongue / Q000637:transplantation*; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000601:surgery*