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Female ventral-onlay buccal mucosal graft urethroplasty supported with martius labial fat pad flap: early results

  • Urology - Original Paper
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Abstract

Purpose

There is a growing interest in reconstructive urology and female urethroplasty. We aimed to report our experience in ventral-onlay buccal mucosa graft (BMG) urethroplasty supported with Martius flap (MF) in treating female urethral stricture disease.

Methods

We retrospectively evaluated data of 18 female patients (ages 35–78) who were diagnosed with urethral stricture disease and underwent ventral-onlay BMG urethroplasty supported with MF by single surgeon in a tertiary referral centre between February 2019 and October 2022. Detailed history, international prostate symptom score (IPSS), pelvic examination, urine flow rate (rate and pattern), post void residual (PVR), storage and voiding phase urodynamic study, and voiding cystourethrography were recorded. At the last visit; the number of urethral dilatations before urethroplasty, time from urethral dilation to urethroplasty, hospital stay, urethral catheterization time, postoperative IPSS, PVR and uroflowmetry values were recorded.

Results

The presenting symptoms were obstructive voiding symptoms in 16 patients. While the mean number of urethral dilatation was 2.11 ± 1.93 (1–7), the mean time from dilatation to urethroplasty was 5.83 ± 5.00 (1–19 months) months. Maximum flow rate increased from 8.36 ± 3.26 ml/sec in preoperative uroflowmetry to 21.45 ± 5.27 ml/sec at the last follow-up (p < 0.001). Post-void residual urine (PVR) decreased from preoperative mean 116.66 ± 105.88 cc to 26.94 ± 22.69 cc postoperatively (p < 0.004). None of the patients developed stricture recurrence, incontinence or vaginal fistula until the last follow-up. The mean follow-up period was 17.28 ± 11.65 (1–35) months.

Conclusions

A ventral-onlay BMG urethroplasty supported with MF represents an effective and reproducible treatment option for FUS in the present study.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Urology, Sakarya University, Training and Research Hospital, Sakarya, Turkey

    Yavuz Tarik Atik, Deniz Gul & Huseyin Aydemir

  2. Faculty of Medicine, Department of Urology, Sakarya University, Sakarya, Turkey

    Burak Uysal, Haci Ibrahim Cimen & Osman Kose

  3. Faculty of Medicine, Department of Gynecology and Obstetrics, Sakarya University, Sakarya, Turkey

    Mehmet Suhha Bostanci

Authors
  1. Yavuz Tarik Atik
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  2. Burak Uysal
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  3. Deniz Gul
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  4. Haci Ibrahim Cimen
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  5. Huseyin Aydemir
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  6. Mehmet Suhha Bostanci
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  7. Osman Kose
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Contributions

YTA: conceptualization, writing—original draft, Haci Ibrahim Cimen: writing—review and editing, BU: writing—original draft, data curation, formal analysis, OK: supervision, writing—review and editing, methodology, HA: data curation, Mehmeh Suhha Bostanci: writing—review and editing. DG: formal analysis, review and editing. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Yavuz Tarik Atik.

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None.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Sakarya University Faculty of Medicine approved this study. Approval reference number is E-71522473-050.01.04-74653-474.

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Atik, Y.T., Uysal, B., Gul, D. et al. Female ventral-onlay buccal mucosal graft urethroplasty supported with martius labial fat pad flap: early results. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-023-03909-2

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