Reconstruction of the female urethra during its destruction: a systematic review and meta-analysis

Мұқаба
  • Авторлар: Vorobev V.A.1,2, Kogan M.I.3, Bogdanov A.B.4,5, Loran O.B.4,5
  • Мекемелер:
    1. Bashkir State Medical University
    2. Irkutsk State Medical University
    3. Rostov State Medical University
    4. State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow
    5. Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation
  • Шығарылым: № 4 (2025)
  • Беттер: 115-123
  • Бөлім: Systematic rewiev
  • URL: https://journals.eco-vector.com/1728-2985/article/view/690481
  • DOI: https://doi.org/10.18565/urology.2025.4.115-123
  • ID: 690481

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

In accordance with the PRISMA protocol, a comprehensive literature search was conducted, and based on a systematic review and meta-analysis, the effectiveness of various surgical approaches for complete or partial urethral destruction in women was evaluated. A total of 36 studies were included, encompassing more than 500 female patients with severe urethral injury. The analysis incorporated retrospective case series, cohort and comparative studies, as well as one systematic review. The primary outcomes assessed were urethral patency restoration, urinary continence, recurrence rate, complications, and the need for re-interventions. Statistical analysis included a meta-analysis of success proportions using a random-effects model; the level of evidence was evaluated according to the GRADE system.

The best outcomes were observed with urethroplasty using autologous tissues (buccal mucosa, vaginal and labial flaps), which provided long-term urethral patency (88.2%; 95% CI, 82–93%) and preservation of continence. Other urinary diversion techniques (urethroclesis, suprapubic fistula, Monti procedure) achieved continence in the majority of patients with severe comorbidities (success rate 78%), but were associated with a high incidence of complications, including infections, stone formation, and progressive renal failure.

Tissue urethroplasty remains the most effective and safest method of urethral reconstruction in women. Minimally invasive procedures should be regarded as temporary measures, while diversion operations should be reserved for the most severe cases.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Vladimir Vorobev

Bashkir State Medical University; Irkutsk State Medical University

Хат алмасуға жауапты Автор.
Email: denecer@yandex.ru
ORCID iD: 0000-0003-3285-5559
SPIN-код: 9896-6243

Doctor of Medical Sciences, M.D., Professor of the Department of Faculty Surgery and Urology, Associate Professor of the Department of Urology and Oncology

Ресей, Ufa; Irkutsk

Mikhail Kogan

Rostov State Medical University

Email: dept_kogan@mail.ru
ORCID iD: 0000-0002-1710-0169
SPIN-код: 6300-3241

Honored Scientist of Russian Federation, M.D., Dr.Sc.(M), Full prof., Head, Dept. of Urology and Human Reproductive Health (with the pediatric Urology and andrology сourse)

Ресей, Rostov-on-Don

Andrey Bogdanov

State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow; Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation

Email: urology@bionika-media.ru
ORCID iD: 0000-0001-5347-8364
SPIN-код: 2997-3211

PhD, Urologist of Urology Division, Associate Professor of Department of Urology and Surgical Andrology

Ресей, Moscow; Moscow

Oleg Loran

State Budgetary Healthcare Institution of the city of Moscow «Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin» of the Department of Health of the City of Moscow; Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation

Email: oleg_loran@gmail.com
ORCID iD: 0000-0002-7531-1511
SPIN-код: 7604-8138

Academician of the Russian Academy of Sciences, Honored Scientist of Russian Federation, M.D., Dr.Sc.(M), Full prof., Head, Dept. of Urology and Surgical Andrology

Ресей, Moscow; Moscow

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Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу
2. Fig. 1. Block diagram of research selection (PRIS diagram)

Жүктеу (116KB)
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3. Fig. 2. Forest diagram of the success of tissue methods of urethral reconstruction; points — success rates, segments — 95% CI

Жүктеу (89KB)
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4. Fig. 3. Forest diagram of urine retention during urinary diversions/occlusion of the urethra. Success = reaching the continent

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