Dorsal onlay buccal mucosal graft urethroplasty in a female patient: a case report from Vietnam

Introduction: Urethral stricture is a rare condition in women that presents challenges for reconstructive surgery. Urethroplasty can be particularly difficult for these patients, especially in developing countries, due to limited infrastructure and concerns about recurrence. Case presentation: In this report, we present a case involving a 60-year-old woman who experienced long-standing urinary difficulties and had a history of multiple urethral dilations. The diagnosis was confirmed via voiding cystourethrogram, retrograde urethrogram, and cystoscopy. The patient underwent urethral reconstruction using an oral mucosa graft to create a dorsal surface for the urethra. Four months after surgery, she had normal urinary function, with uroflowmetry showing a maximum flow rate (Qmax) exceeding 15 mL/s and no signs of postoperative incontinence. Discussion: For a female with a urethral stricture, studies indicate that urethroplasty, particularly using a dorsal onlay buccal mucosa graft, is the gold standard for treatment. However, there are relatively few cases utilizing this technique due to concerns about recurrence risk and its complexity. The results highlight the effectiveness and long-term success of buccal mucosa graft urethroplasty, especially in challenging cases of urethral stricture that are difficult to treat using traditional methods. Conclusion: Dorsal onlay oral mucosa graft urethroplasty is an effective and viable option for treating female urethral stricture, especially when performed by an experienced surgeon. However, further studies with larger sample sizes and longer follow-up are needed to confirm the long-term efficacy and safety of oral mucosal grafts for urethral reconstruction in females.