Urethral Strictures in Women
A urethral stricture is a collection of scar tissue in the urethra, the urinary channel as it travels out of the bladder. This scar tissue blocks the flow of urine as comes out, often resulting in incomplete urinary emptying, recurrent urinary tract infections, and other troublesome urinary symptoms.
Urethral strictures in women are very rare and are treated best by reconstructive urologists. Many women are treated with routine dilations (stretching of the scar tissue without definitive repair). Unfortunately these strictures frequently return, until the urethral stricture is formally repaired with a surgical procedure called urethroplasty.
What is urethroplasty?
It is small surgery performed within the vagina to fix the urethral stricture. There are several methods used to surgically fix the urethral stricture, however, one of the most reliable methods is taking a small piece of the lining of the inner cheek (buccal graft) to rebuild the urethra. The lining of the mouth (buccal mucosa) is very similar to the lining of the urethra; it fights infection, it is used to a moist environment, and an additional advantage is the graft site heals very quickly. In fact within about 2 weeks there is a completely new lining that forms where the graft was removed from the inner cheek.
The surgery typically takes about 2-3 hours and patients go home the same day of surgery with a catheter in place. The catheter is usually removed at 2-4 weeks after the surgery.
What is the follow up after surgery?
Patients return to clinic to remove the catheter and then they come back to clinic every 3-6 months after surgery for the first 2-3 years. Patients are typically asked to perform a flow test and a cystoscopy to ensure the area of the stricture is definitively fixed. Patients can then return for yearly or as-needed appointments.