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de Toledo et al. Plast Aesthet Res 2022;9:5 Plastic and
DOI: 10.20517/2347-9264.2021.103
Aesthetic Research

Review Open Access

Female urethral stricture: techniques for
reconstruction

Ignacio Alvarez de Toledo, Jessica DeLong

Department of Urology, Eastern Virginia Medical School, Norfolk, VA 23462, USA.
Correspondence to: Dr. Jessica DeLong, Department of Urology, Eastern Virginia Medical School, Urology of Virginia, 225
Clearfield Avenue, Virginia Beach, VA 23462, USA. E-mail: jessicadelong@gmail.com

How to cite this article: de Toledo IA, DeLong J. Female urethral stricture: techniques for reconstruction. Plast Aesthet Res
2022;9:5. https://dx.doi.org/10.20517/2347-9264.2021.103

Received: 16 Sep 2021 First Decision: 25 Oct 2021 Revised: 11 Nov 2021 Accepted: 7 Dec 2021 Published: 14 Jan 2022

Academic Editors: Miroslav L. Djorjdjevic, Stan Monstrey Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Female urethral stricture (FUS) is a rare condition. It was not studied robustly for many years, but interest has
grown recently in the reconstructive urology community, leading to an increase in publications. In this review, we
gather the latest data regarding FUS and its different therapeutic options. Studies are summarized, split by
technique. We also review the recently published European Guidelines. In addition, we share our preferred surgical
technique and our views on future options. Diagnosing FUS can often be challenging and requires a high index of
clinical suspicion. Its vague clinical symptoms and empiric initial treatments combine to make FUS an
underdiagnosed condition. The lack of consensus on how to define FUS also compounds the problem. Appropriate
diagnosis requires thorough investigation, and ancillary studies such as video urodynamics, cystoscopy, and
voiding cystourethrogram may be useful. Treatment options range from conservative management to definitive
procedures, although studies have shown that conservative measures such as urethral dilation have a low success
rate overall. Within definitive management, augmented urethroplasty - using either flaps or grafts, has proven to be
the gold standard. Both have shown excellent results over time; however, there is insufficient data available to
recommend one over the other. Contemporary data has an overall poor level of evidence. Although challenging due
to the rarity of the problem, a proper randomized controlled clinical trial comparing the principal surgical options
and their outcomes would be beneficial and would allow for more informed decision making when considering
options for women with urethral stricture.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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