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Ventral onlay buccal mucosa graft urethroplasty for female urethral stricture improves female sexual functions

International Journal of Impotence Research (2023)Cite this article

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Abstract

Female urethroplasty provides excellent results with high success rates in the treatment of female urethral stricture (FUS), but sexual functions after urethroplasty is another concern and have not been adequately investigated. We aimed to evaluate changes in the sexual functions of patients undergoing ventral onlay buccal mucosa graft urethroplasty (VOBMGU). We retrospectively evaluated 18 patients who underwent VOBMGU supported with a Martius labial fat pad flap (MLFPF) in our tertiary referral centre, between 2019 and 2021. After excluding patients who were sexually inactive and those with missing postoperative data, 13 patients were included. Surgical outcomes were assessed with uroflowmetry, the American Urological Association symptom score (AUA-SS), and Urogenital Distress Inventory (UDI)−6. Short Form-36 (SF-36) was used to evaluate the quality of life (QoL). Sexual function was assessed using the Female Sexual Function Index (FSFI) both preoperatively and at 6 months following surgery. The median age was 50 (IQR:44–62) years. There was no surgical failure, and none of the patients developed incontinence or stricture recurrence during a median follow-up of 30 (IQR:12–30) months. The median maximum flow rate increased from 9.2 (IQR:5–11.5) to 19 (IQR:17.35–27.10) ml/s (p = 0.001), the median post-void residual (PVR) volume decreased from 80 (IQR:0–205) to 20 (IQR:10–45) ml (p = 0.021), the median AUA-SS decreased from 19 (IQR:14–22) to 6 (IQR:4–8) (p = 0.001), and the median UDI-6 score decreased from 12 (IQR:6.5–16) to 4 (IQR:2–9) (p = 0.008) postoperatively. Bodily pain and general health perception domains and the physical component summary score were significantly improved in the SF-36 (p = 0.015, 0.022, and 0.009, respectively). The median total FSFI score increased from 17.40 (IQR:1.95–23.65) to 22.60 (IQR:5–24.95) postoperatively (p = 0.004). Improvements were observed in all domains (p < 0.05) except the arousal (p = 0.058) and pain (p = 0.104) domains of the FSFI. We concluded that VOBMGU has good early functional results and improves female sexual function.

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Fig. 1: Surgical steps of the procedure-1.
Fig. 2: Surgical steps of the procedure-2.

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Data availability

Data supporting the results of this study are available from the corresponding author on reasonable request.

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Authors and Affiliations

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

    Deniz Gul & Yavuz Tarik Atik

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

    Burak Uysal, Haci Ibrahim Cimen & Osman Kose

  3. Sakarya Sadıka Sabancı State Hospital, Department of Urology, Sakarya, Turkey

    Anil Erdik

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

    Mehmet Suhha Bostanci

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  1. Deniz Gul
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Contributions

Conceptualisation: DG, MSB, OK; Methodology: DG, YTA, HIC; Data extraction: BU, YTA, AE; Formal analysis and investigation: DG, BU, AE; Writing—original draught preparation: DG, HIC, OK; Writing—review and editing: YTA, HIC, MSB, OK.

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Correspondence to Deniz Gul.

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Gul, D., Uysal, B., Atik, Y.T. et al. Ventral onlay buccal mucosa graft urethroplasty for female urethral stricture improves female sexual functions. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00743-z

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