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Meatal Stenosis and Stricture of the Female Urethra

Definition

A narrowing of the female urethra is usually found in the distal part (meatal stenosis). An anatomically fixed narrowing under 14 CH is considered significant (Osman et al., 2013).The regular width of the urethra is more than 20 Charriere. In girls, the minimal width of the urethra can be approximated using the following formula:

Urethral width [in Charriere] = age + 10

Signs and Symptoms

Dysuria, urgency and recurrent infections are common symptoms, sometimes caused by urethral narrowing. The pathophysiological significance of an urethral narrowing without incomplete bladder emptying or urinary retention is controversial.

Diagnostic Workup

Cystoscopy and calibration of the urethra with Bougie a boule is done to determine the width of the urethra. General anesthesia is necessary if cystoscopy or urethral calibration is impossible under local anesthesia. It is controversial if the subvesical obstruction should be confirmed with urodynamic studies.

Treatment: Meatotomy

The necessity of an operation should be carefully assessed. Meatal stenosis is treated with a sagittal incision of the fibrotic ring at 6 o'clock (meatotomy). The urethral mucosa is readapted in transverse direction (urethral mucosa with vulva mucosa). A blind urethrotomy (Otis) is reserved for proximal strictures of the female urethra.

References

N. I. Osman, A. Mangera, and C. R. Chapple, “A systematic review of surgical techniques used in the treatment of female urethral stricture.,” Eur Urol., vol. 64, no. 6, pp. 965–973, 2013.

  Deutsche Version: Meatusstenose der weiblichen Harnröhre