Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 9/2013

01-09-2013 | Review Article

Female urethral dilation

Authors: Tony Bazi, Gael Abou-Ghannam, Raja Khauli

Published in: International Urogynecology Journal | Issue 9/2013

Login to get access

Abstract

Introduction and hypothesis

The aim of this manuscript is to review the subject of urethral dilation (UD) in female patients and to conduct a critical appraisal of the available evidence for its use.

Methods

We used an online search of electronic databases.

Results

UD has been cited as a treatment option for various conditions that do not share common etiologies and that affect the lower urinary tract in female patients. Outcome measurement was not consistent, even when performed for the same conditions. A total of six randomized controlled trials failed to prove any benefit for UD in repetitive urinary tract infections (UTI), urethral syndrome, and overactive bladder.

Conclusions

Conflicting results and diverse opinions have characterized the use of UD until present time. Professional societies are urged to attend to this issue, and to identify possible areas where UD could be potentially investigated.
Literature
1.
Lemack GF, Foster B, Zimmern PE (1999) Urethral dilation in women: a questionnaire-based analysis of practice patterns. Urology 54:37–43PubMedCrossRef
2.
Masarani M, Willis RG (2006) Urethral dilatation in women: urologists’ practice patterns in the UK. Ann R Coll Surg Engl 88:496–498PubMedCrossRef
3.
Metwalli AR, Cheng EY, Kropp BP, Pope JC (2002) The practice of urethral dilation for voiding dysfunction among fellows of the section of urology of the American Academy of Pediatrics. J Urol 168:1764–1767PubMedCrossRef
4.
Walsh PC, Petrick AB, Vaugh ED, Wein AJ (1998) Campbell’s urology, 7th edn. W.B. Saunders, Philadelphia, p 162
5.
Santucci RA, Payne CK, Anger JT et al (2008) Office dilation of the female urethra: a quality of care problem in the field of urology. J Urol 180:2068–2075PubMedCrossRef
6.
Klijn AJ, Bochove-Overgaauw D, Winkler-Seinstra PL, Dik P, de Jong TP (2012) Urethral meatus deformities in girls as a factor in dysfunctional voiding. Neurourol Urodyn 31:1161–1164PubMedCrossRef
7.
Romman AN, Alhalabi F, Zimmern PE (2012) Distal intramural urethra pathology in women. J Urol 188:1218–1223PubMedCrossRef
8.
Blaivas JG, Santos JA, Tsui JF, Deibert CM, Rutman MP et al (2012) Management of urethral stricture in women. J Urol 188:1778–1782PubMedCrossRef
9.
Eastwood DM, Goldman M, Farrar DJ (1984) Urethral overdilatation in females with lower urinary tract symptoms. J R Soc Med 77:639–642PubMed
10.
Giesy JD, Finn JC, Hermann GD, Kinney TB, Fogarty TJ (1984) Coaxial balloon dilation and calibration of urethral strictures. Am J Surg 147(5):611–614PubMedCrossRef
11.
Zimmern PE (1997) Use of the lidocaine gel container for urethral dilation and intravesical drug delivery. Urology 49:618–619PubMedCrossRef
12.
Stevens WE (1936) Congenital obstructions of the female urethra. JAMA 106:189CrossRef
13.
McCannel DA, Haile W (1982) Urethral narrowing and its treatment: a possible solution for the problems of recurrent urinary infection and the irritable bladder. Int Urol Nephrol 14:407–414PubMedCrossRef
14.
Davis DM (1956) The relationship between urethral resistance and chronic urinary tract disease in women. J Urol 76:270–275PubMed
15.
Essenhigh DM, Ardran GM, Cope V (1968) A study of the bladder outlet in lower urinary tract infections in women. Br J Urol 40:268–277PubMedCrossRef
16.
Park JM, McGuire EJ, Koo HP, Schwartz AC, Garwood CK et al (2001) External urethral sphincter dilation for the management of high risk myelomeningocele: 15-year experience. J Urol 165:2383–2388PubMedCrossRef
17.
Kiddoo DA, Canning DA, Snyder HM 3rd, Carr MC (2006) Urethral dilation as treatment for neurogenic bladder. J Urol 176:1831–1833PubMedCrossRef
18.
Graham JB, King LR, Kropp KA, Uehling DT (1967) The significance of distal urethral narrowing in young girls. J Urol 97:1045–1049PubMed
19.
Immergut MA, Wahman GE (1968) The urethral caliber of female children with recurrent urinary tract infections. J Urol 99:189–190PubMed
20.
Uehling D (1978) The normal caliber of the female urethra. J Urol 120:176–177PubMed
21.
Tanagho EA, McCurry E (1971) Pressure and flow rate as related to lumen calibre and entrance infection in girls. J Urol 105:583–585PubMed
22.
Glenn JF (1983) Urologic surgery, 3rd edn. JB Lippincott Co, Philadelphia, p 681
23.
Ostergard DR (1980) Bladder pillar block anesthesia for urethral dilatation in women. Am J Obstet Gynecol 136:187–188PubMed
24.
Hoebeke P, Depauw P, Van Laecke E, Oosterlinck W (1997) The use of Emla cream as anaesthetic for minor urological surgery in children. Acta Neurol Belg 65:25–28
25.
Hendry WF, Stanton SL, Williams DI (1973) Recurrent urinary infections in girls: effects of urethral dilation. Br J Urol 45:72–83PubMed
26.
Lyon RP, Smith DR (1963) Distal urethral stenosis. J Urol 89:414–421PubMed
27.
Halverstadt DB, Leadbetter GW Jr (1968) Internal urethrotomy and recurrent urinary tract infection in female children. Results in the management of infection. J Urol 100:297–302PubMed
28.
McLean P, Emmett JL (1969) Internal urethrotomy in women for recurrent infection and chronic urethritis. J Urol 101:724–728PubMed
29.
Zerhau P, Holubar J, Hnilicka B, Mraz J (1995) Effectiveness of dilatation of distal urethral stenosis in girls. Rozhl Chir 74:389–391PubMed
30.
Lyon RP, Tanagho EA (1965) Distal urethral stenosis in little girls. J Urol 93:379–381PubMed
31.
Lyon RP, Marshall S (1971) Urinary tract infections and difficult urination in girls: long-term follow up. J Urol 105:314–317PubMed
32.
Wein AJ, Schoenberg HW (1972) A review of 402 girls with recurrent urinary tract infection. J Urol 107:329–331PubMed
33.
Kendall AR, Karafin L (1972) Urinary tract infection in children: fact and fantasy. J Urol 107:1068–1072PubMed
34.
Kaplan GW, Sammons TA, King LR (1973) A blind comparison of dilatation, urethrotomy and medication alone in the treatment of urinary tract infection in girls. J Urol 109:917–919
35.
Fair WR, Govan DE, Fiedland GW, Filly RQ (1974) Urinary tract infections in children-part I: young girls with non-refluxing ureters. West J Med 121:366–373PubMed
36.
Harvard BM (1970) Revision of the external urinary meatus in girls: a clinical upraisal. J Urol 103:236–242PubMed
37.
Hoebeke P, Van Laecke E, Raes A, Van Gool JD, Vande Walle (1999) Anomalies of the external urethral meatus in girls with non-neurogenic bladder sphincter dysfunction. BJU 83:294–298CrossRef
38.
Nitti VW, Tu LM, Gitlin J (1999) Diagnosing bladder outlet obstruction in women. J Urol 161:1535–1540PubMedCrossRef
39.
Groutz A, Blaivas JG, Chaikin DC (2000) Bladder outlet obstruction in women: definition and characteristics. Neurourol Urodyn 19:213–220PubMedCrossRef
40.
Keegan KA, Nanigian DK, Stone AR (2008) Female urethral stricture disease. Curr Urol Rep 9:419–423PubMedCrossRef
41.
42.
Schwender CE, Ng L, McGuire E et al (2006) Technique and results of urethroplasty for female stricture disease. J Urol 175:976–980PubMedCrossRef
43.
Attah CA, Mbonu O, Anikwe RM (1982) Treatment of urethral strictures in university of Nigeria teaching hospital. Urology 20:491–494PubMedCrossRef
44.
Kuo HC (2005) Videourodynamic characteristics and lower urinary tract symptoms of female bladder outlet obstruction. Urology 66:1005–1009PubMedCrossRef
45.
Smith AL, Ferlise VJ, Rovner ES (2006) Female urethral strictures: successful management with long-term clean intermittent catheterization after urethral dilatation. BJU Int 98:96–99PubMedCrossRef
46.
Stanton (1923) Renal colic. Am J Obstet Gynecol 5:72
47.
Takao M, Asano T, Nakamura H (1992) Urodynamic studies before and after gradual urethral dilatation with metal sounds for female urethral stricture. Hinyokika Kiyo 38:15–17PubMed
48.
49.
50.
Yee CH, Ho LY, Hung HH, Chan WH (2012) The effect of urethral calibration on female primary bladder outlet obstruction. Int Urogynecol J 23:217–221PubMedCrossRef
51.
Basu M, Duckett J (2009) The effect of urethral dilatation on pressure flow studies in women with voiding dysfunction and overactive bladder. Int Urogynecol J 20:1073–1077CrossRef
52.
Basu M, Duckett J (2011) A randomised controlled trial comparing cystoscopy with cystoscopy and urethral dilatation in women with detrusor overactivity and voiding dysfunction. Basu M, Duckett J. Presented at IUGA international meeting, Lisbon Portugal. Int Urogynecol J 22(Suppl1):S186–S187
53.
54.
Van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M et al (2008) Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 53:60–67PubMedCrossRef
55.
56.
Folsom AI (1931) The female urethra a clinical and pathologic study. JAMA 97:1345CrossRef
57.
Ormond JK (1935) Non-purulent urethritis in women—granular urethritis—cystalgia.. J Urol 33:483
58.
Fiedlander JI, Shorter B, Moldwin RM (2012) Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int 109:1584–1591CrossRef
59.
60.
61.
Carson CC, Segura JW, Osborne DM (1980) Evaluation and treatment of the female urethral syndrome. J Urol 124:609–610PubMed
62.
Stamm WE, Wagner KF, Amsel R, Alexander ER, Turck M et al (1980) Causes of the acute urethral syndrome in women. N Engl J Med 303:409–415PubMedCrossRef
63.
Parziani S, Costantini E, Petroni PA, Ursini M, Porena M (1994) Urethral syndrome: clinical results with antibiotics alone or combined with estrogen. Eur Urol 26:115–119PubMed
64.
Rutherford AJ, Hinshaw K, Essenhigh DM et al (1988) Urethral dilatation compared with cystoscopy alone in the treatment of women with recurrent frequency and dysuria. Br J Urol 61:500–504PubMedCrossRef
65.
Sand PK, Bowen LW, Ostergard DR, Bent A, Panganiban R (1989) Cryosurgery versus dilation and massage for the treatment of recurrent urethral syndrome. J Reprod Med 34:499–504PubMed
66.
Bergman A, Karram M, Bhatia NN (1989) Urethral syndrome: a comparison of different treatment modalities. J Reprod Med 34:157–160PubMed
67.
Dik P, Klijn AJ, van Gool JD, de Jong-de Vos van Steenwijk CC, de Jong TP (2006) Early start to therapy preserves kidney function in spina bifida patients. Eur Urol 49:908–913PubMedCrossRef
68.
Johnston JH, Kathel BL (1971) The obstructed neurogenic bladder in the newborn. Br J Urol 43:206–210PubMedCrossRef
69.
Shochat SJ, Perlmutter AD (1972) Myelodysplasia with severe neonatal hydronephrosis: the value of urethral dilatation. J Urol 107:146–148PubMed
70.
Lapides J, Diokno AC, Silber SJ, Lowe BS (1972) Clean intermittent self-catheterization in the treatment of urinary tract disease. J Urol 107:458–461PubMed
71.
McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 126:205–209PubMed
72.
Wang SC, McGuire EJ, Bloom DA (1989) Urethral dilation in the management of urological complications of myelodysplasia. J Urol 142:1054–1055PubMed
73.
Bloom DA, Knechtel JM, McGuire EJ (1990) Urethral dilation improves bladder compliance in children with myelomeningocele and high leak point pressures. J Urol 144:443–444
74.
Gamé X, Mouracade P, Chartier-Kastler E, Viehweger E, Moog R et al (2009) Botulinum toxin-A (Botox) intradetrusor injections in children with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review. J Pediatr Urol 5:156–164PubMedCrossRef
75.
Karram MM, Segal JL, Vassallo BJ, Kleeman SD (2003) Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 101:929–932PubMedCrossRef
76.
Klutke C, Siegel S, Carlin B, Paszkiewicz E, Kirkemo A et al (2001) Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology 58:697–701PubMedCrossRef
77.
Paick J, Ku JH, Shin JW, Oh S, Kim SW (2005) Complications associated with the tension-free vaginal tape procedure: the Korean experience. Int Urogynecol J Pelvic Floor Dysfunct 16:215–219PubMedCrossRef
78.
Rardin CR, Rosenblatt PL, Kohli N, Miklos JR, Heit M et al (2002) Release of tension-free vaginal tape for the treatment of refractory postoperative voiding dysfunction. Obstet Gynecol 100:898–902PubMedCrossRef
79.
Sokol AI, Jelovsek JE, Walters M, Paraiso MFR, Barber MD (2005) Incidence and predictors of prolonged urinary retention after TVT with and without concurrent prolapse surgery. Am J Obstet Gynecol 192:1537–1543PubMedCrossRef
80.
Vassallo BJ, Kleeman SD, Segal J, Karram MM (2003) Urethral erosion of a tension- free vaginal tape. Obstet Gynecol 101:1055–1058PubMedCrossRef
81.
Bazi TM, Hamade RF, Abdallah Hajj Hussein I, Abi Nader K, Jurjus A (2007) Polypropylene midurethral tapes do not have similar biologic and biomechanical performance in the rat. Eur Urol 51:1364–1373PubMedCrossRef
82.
Han K, Glazier DB, Cummings KB, Barone JG (1998) Periurethral haematomas in child following urethral dilation for dysfunctional voiding. Br J Urol 81:920–921PubMedCrossRef
Metadata
Title
Female urethral dilation
Authors
Tony Bazi
Gael Abou-Ghannam
Raja Khauli
Publication date
01-09-2013
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 9/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2055-5

Other articles of this Issue 9/2013

International Urogynecology Journal 9/2013 Go to the issue

Original Article

Fibroblasts from women with pelvic organ prolapse show differential mechanoresponses depending on surface substrates

Original Article

Expectant management of cystotomy at the time of midurethral sling placement: a retrospective case series

Original Article

Diagnosis of female urethral diverticulum using transvaginal contrast-enhanced sonourethrography

Original Article

Single-incision sling compared with transobturator sling for treating stress urinary incontinence: a randomized controlled trial

Original Article

European content validation of the Self-Assessment Goal Achievement (SAGA) questionnaire in patients with overactive bladder

Original Article

Prevalence of urinary and fecal incontinence in Chinese women during and after their first pregnancy