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Meta-Analysis
. 2025 Jun 26;43(1):397.
doi: 10.1007/s00345-025-05773-4.

Comparing ventral and dorsal oral mucosal graft urethroplasty in female urethral stricture: a systematic review and meta-analysis

Mazhar Ortac  1 , M Firat Ozervarli  2 , Rifat Burak Ergul  2 , Arda Tunc Aydinoglu  2 , Mevlut Melih Bicer  2 , Teresa Olsen Ekerhult  3 , Senol Tonyali  2 , Assoc Prof  2
Affiliations
Meta-Analysis

Comparing ventral and dorsal oral mucosal graft urethroplasty in female urethral stricture: a systematic review and meta-analysis

Mazhar Ortac et al. World J Urol. .

Abstract

Purpose: Reconstructive surgical options have become an alternative for female urethral stricture. Dorsal and ventral methods using oral mucosa grafts have been described, but their superiority over each other has not been evaluated. In this meta-analysis, the outcomes of dorsal and ventral techniques with oral mucosa graft in female urethroplasty have been compared.

Material and method: A systematic search of Pubmed, Scopus and Web of Science databases was performed according to the Preferred Reporting Items For Systematic Review And Meta-Analysis statement. Manuscripts published until February 2025 that reported the use of dorsal or ventral surgical approaches with oral mucosa grafts in female urethroplasty included. Success, determined based on the recurrence rate, was analyzed and compared between both groups. Complications were presented in both groups to evaluate the safety of the surgical technique.

Results: A total of 320 studies were identified, with 25 meeting the inclusion criteria. The meta-analysis, including four comparative cohort studies, showed no significant difference in surgical success between the dorsal (62/69 patients) and ventral (93/103 patients) techniques (OR = 0.84, 95% CI: 0.30-2.36, p = 0.74). In the pooled analysis combining both comparative and non-comparative studies, the success rates for the dorsal and ventral techniques were 92.1% (95% CI: 89.1-95.1) and 95.5% (95% CI: 92.8-98.2), respectively, with no significant heterogeneity. A total of 4 cases of stress urinary incontinence complications were reported in the ventral approach, while 2 cases were reported using the dorsal approach. The majority of the studies (21 out of 25) provided Level 4 evidence, with only two randomized controlled trials reaching Level 2.

Conclusion: This meta-analysis confirms that both dorsal and ventral approaches are effective for treating female urethral stricture, with high success rates. There was no statistically significant difference in success rates between the ventral and dorsal approaches. Surgical approach selection should depend on patient factors and surgeon expertise to achieve optimal outcomes.

Keywords: Buccal mucosa; Dorsal; Female urethroplasty; Oral mucosal graft; Ventral.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflict of interest to declare. Ethical approval: Not applicable. Informed consent: Not applicable.

Figures

Fig. 1
Fig. 1
Prisma flowchart adapted for the selection of studies included
Fig. 2
Fig. 2
a Forest plot of success rates in urethroplasty using the dorsal technique. b Forest plot of success rates in urethroplasty using the ventral technique. c Forest plot of success rates in urethroplasty comparing dorsal and ventral technique
Fig. 3
Fig. 3
a Funnel plot of publication bias in dorsal technique. b Funnel plot of publication bias in ventral technique
See this image and copyright information in PMC

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References

    1. Spilotros M, Malde S, Solomon E, Grewal M, Mukhtar BM, Pakzad M, Hamid R, Ockrim JL, Greenwell TJ (2017) Female urethral stricture: a contemporary series. World J Urol 35(6):991–995 - PubMed
    1. Malde S, Solomon E, Spilotros M, Mukhtar B, Pakzad M, Hamid R, Ockrim J, Greenwell T (2019) Female bladder outlet obstruction: common symptoms masking an uncommon cause. Low Urin Tract Symptoms 11(1):72–77 - PubMed
    1. Nitti VW, Tu LM, Gitlin J (1999) Diagnosing bladder outlet obstruction in women. J Urol 161(5):1535–1540 - PubMed
    1. Kuo HC (2005) Videourodynamic characteristics and lower urinary tract symptoms of female bladder outlet obstruction. Urology 66(5):1005–1009 - PubMed
    1. Campbell J, Vanni AJ, Kowalik CG (2022) An update on female urethral stricture disease. Curr Urol Rep 23(11):303–308 - PubMed

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