Female Urethra Stricture Disease: Evaluation and Surgical Management
Oluwarotimi S. Nettey, MD, MHS, discusses the complexities of female urethral stricture disease, which, although less common than in men, often goes underdiagnosed due to its non-specific symptoms and rarity.
In this 18-minute talk, Dr. Nettey shares this disease often coincides with lower urinary tract symptoms. While its exact causes are largely idiopathic, medical procedures like catheterization, radiation, and surgeries, as well as conditions like vaginal atrophy in postmenopausal women, can increase the risk.
Diagnosis typically involves cystoscopy, with additional imaging options providing insights into stricture location and bladder morphology. Uroflowmetry and video urodynamics offer further understanding of urinary dynamics, helping tailor treatment approaches. Non-surgical management includes vaginal estrogen and corticosteroids.
Nettey shares that endoscopic dilation is a first-line treatment but has diminishing returns with repeated procedures, while open surgical repair becomes essential in complex cases. She underscores the need for individualized management and referrals to reconstructive specialists for challenging cases, emphasizing the importance of a methodical approach in addressing this underrecognized condition.
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