Reconstruction of Female Urethra with Tubularized Anterior Vaginal Flap
Introduction: Female urethral injury is a rare disease. Causes of urethral injuries are prolonged obstructed labour, gynaecological surgeries like vaginoplasty and post traumatic urethral injuries. The present study was conducted to evaluate outcome of female urethral reconstruction using tubula...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8088/19502_CE(RA1)_F(T)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Female urethral injury is a rare disease. Causes of
urethral injuries are prolonged obstructed labour, gynaecological
surgeries like vaginoplasty and post traumatic urethral injuries.
The present study was conducted to evaluate outcome of
female urethral reconstruction using tubularized anterior vaginal
wall flap covered with fibroadipose martius flap and autologous
fascia sling in patients with urethral loss.
Aim: Aim of study was to evaluate outcome of reconstruction of
female urethra with tubularized anterior vaginal flap.
Materials and Methods: Retrospective analysis of all the
patients with complete urethral loss was done from August 2008
to July 2015. Total seven patients were included in study. All
patients presenting with total urethral loss were included. These
patients were treated with tubularized anterior vaginal flap.
Neourethra was covered with Martius labial flap and autologous
fascia lata or rectus abdominis fascia sling. Most common cause
of urethral loss was obstructed labour (57.1%). Postoperatively
patients were assessed for continence, urine flow rate,
ultrasound for upper urinary tract and post void residue.
Results: Mean operative time was 180 minutes (160-200
minutes) and Intraoperative blood loss was 220ml (170-260 ml).
Mean postoperative hospital stay was eight days (seven to nine
days) Mean post surgery maximum urine flow rate was more
than 15ml/sec (6.7-18.2ml/sec) and mean post void residual
urine was 22.5ml (10-50ml). Median follow-up time was 35
months.
All patients were catheter free and continent post three weeks
of surgery except one patient who developed mild stress urinary
incontinence. One patient developed urethral stenosis which
was managed by intermittent serial urethral dilatation.
Conclusion: Female neourethral reconstruction with tabularized
anterior vaginal flap and autologous pubovaginal sling is
feasible in patients of total urethral loss with success rate of
approximately 86%. It should be considered in patients of
complete urethral loss with adequate healthy vaginal tissue. |
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| ISSN: | 2249-782X 0973-709X |