Editing AUA: Urethral Stricture Disease (2023) (section)

==Female Urethral Stricture==

=== Epidemiology ===

*Relatively rare

=== Causes ===
*'''Most common etiology is iatrogenic'''
**Patients will often have a history of painful or traumatic catheterization or multiple urethral dilations, which can lead to fibrosis from bleeding and extravasation.
*Other causes
**Blunt pelvic trauma
**Obstetric complications, particularly cephalopelvic disproportion
**Malignancy
**Radiation
**Urethral or/and vaginal atrophy
**Recurrent infections
**Skin disease such as lichen planus and LS.

=== Diagnosis and Evaluation ===
*History and Physical Exam
**History
***Storage or voiding symptoms
****LUTS
*****Hesitancy, poor flow, frequency urgency
****Recurrent UTI
****Urethral pain
****Acute urinary retention
***Can impact QoL
**Physical exam
***Pelvic exam
*Labs
**Urinalysis +/- culture
*Imaging
**Endourethral MRI, ultrasonogram, and CT scan can confirm presence of periurethral fibrosis and exclude associated abnormalities
*Other
**Post-void residual
***High PVR
*An inability to pass even a small catheter due to stenosis in the distal urethra is suggestive of the diagnosis of stricture, although the caliber of the female urethra at which pathological conditions may arise is unknown.

=== Management ===
*'''Urethroplasty should be offered to patients with female urethral strictures'''
**'''Low efficacy of endoscopic treatment'''
*Urethroplasty may be performed using oral mucosa grafts, vaginal flaps, or a combination of these techniques.