Journal of Reconstructive Urology

.: REVIEW
Kadın Üretra Darlıkları
Female Urethral Strıcture
Mehmet SEVİMa, Bekir ARASb
aÜroloji Kliniği, Viranşehir Devlet Hastanesi, Şanlıurfa, TÜRKİYE
bÜroloji ABD, Kütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi, Kütahya, TÜRKİYE
J Reconstr Urol. 2019;9(2):57-62
doi: 10.5336/urology.2019-70981
Article Language: TR
Full Text
ÖZET
 Mesane çıkım tıkanıklığı, alt üriner sistem şikâyetleri ile başvuran hastalarda akılda bulundurulması gereken etiyolojik nedenlerden biridir. Üretra darlığı ise mesane çıkım tıkanıklığı tanısı almış olan kadın hastaların yaklaşık %4-13'ünde izlenir. Üretra darlığı; içeriden veya dışarıdan herhangi bir sebeple, idrar çıkımını kısmi olarak azaltan veya tamamen ortadan kaldıran ve lümeni daraltan sebeplerle meydana gelebilir. Kadınlarda üretra darlığı belirtileri oldukça değişkendir. Hastalar, idrar yapmaya başlarken zorlanma, kesik kesik işeme, idrar akım hızında azalma, sıkışma hissi, dizüri, tekrarlayan üriner sistem enfeksiyonları veya idrar retansiyonu ile başvurabilir. Bu nedenle, alt üriner sistem şikâyetleri ile başvuran kadın hastalarda oldukça nadir görülmesi ve belirtilerin farklılık göstermesi nedeni ile üretra darlığı tanısı koymak oldukça güçtür. Kadın üretra darlığı, kateterizasyonda veya fleksibl sistoskopi sırasında güçlükle karşılaşıldığında akla getirilmelidir. Kadın üretra darlıklarının nadir görülmesi ve yüksek kaliteli çalışmaların az sayıda olması nedeni ile, tedavi yöntemlerine ilişkin endikasyonlar da iyi tanımlanmamıştır. Başarı oranları tartışmalı da olsa, tedavi seçenekleri üretra dilatasyonu, self kateterizasyon, internal üretrotomi ve üretroplastidir. Birinci basamak tedavide sıklıkla üretra dilatasyonu uygulansa da yüksek rekürrens oranları ve tekrarlayan dilatasyonlar sonucunda ilerleyici periüretral fibrozise bağlı olarak kür şansı düşüktür. Üretroplasti, tek girişimle sağlanan yüksek kür oranları nedeni ile altın standart tedavi hâline gelmiştir. Biz de bu çalışmada, literatür bilgileri eşliğinde kadın üretra darlıklarını anlatmayı amaçladık.

Anahtar Kelimeler: Üretra; kadın üretra darlığı; üretroplasti
ABSTRACT
 Bladder outlet obstruction is one of the etiologic factors that should be kept in mind in patients presenting with lower urinary tract symptoms. Urethral stricture is observed in approximately 4- 13% of female patients diagnosed with bladder outlet obstruction. Urethral stricture; it may occur for any reason, either internally or externally, that partially or completely eliminate urine output and narrow the lumen. Symptoms of urethral stricture in women are quite variable. Patients may present with difficulty in urination, intermittent voiding, decreased urinary flow rate, urgency, dysuria, recurrent urinary tract infections, or urinary retention. Therefore, it is very difficult to diagnose urethral stricture in female patients presenting with lower urinary tract symptoms because of its rarity and symptoms vary. The diagnosis of female urethral stenosis should be considered when difficulty is encountered during catheterization or flexible cystoscopy. Because female urethral strictures are rare and high quality studies are rare, indications for treatment modalities have not been well defined. Although the success rates are controversial, treatment options include urethral dilatation, self-catheterization, internal urethrotomy and urethroplasty. Urethral dilatation is frequently performed but the chance of cure is low due to high recurrence rates and recurrent dilatations due to progressive periurethral fibrosis. Uretroplasty has become the gold standard treatment due to the high cure rates achieved in one procedure. In this article, we aimed to describe female urethral strictures in the light of literature.

Keywords: Urethra; female urethral stenosis; urethroplasty
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