Early Catheter Removal on Seventh Postoperative Day Following Ventral Inlay Buccal Mucosa Graft Urethroplasty for Female Urethral Stricture: A Pilot Study

Introduction: While the ideal catheterisation time following augmentation urethroplasty is unknown, there is emerging evidence of comparable long-term results of decreasing it in male urethroplasties. This has not been studied in females. Prolonged catheterisation leads to increased patient discomfort and catheter-related urinary-tract-infections (CAUTI). We attempted to study the feasibility and efficacy of catheter removal on the seventh postoperative day following ventral inlay buccal mucosal graft urethroplasty (VI BMGU) for female urethral stricture (FUS). Methods: This was a single-centre, prospective observational pilot study conducted between May 2023 and July 2024. [Ethics committee approval: T/IM-NF/Uro/22/177; Clinical Trials Registry of India: CTRI/2023/05/066957]. Consenting females undergoing VI BMGU for FUS were included. The primary objective was success rate at a minimum follow-up of 6 months, while secondary objectives were a comparison of the American-Urological-Association (AUA) symptom score, maximum urinary flow rate (Qmax) and Postvoid Residual volume (PVR) and CAUTI rate per 1000 urinary catheter days. Results: Twenty three patients were recruited, and 22 were included in the final analysis with a median follow up of 12 (9-15) months. There were three recurrences, with an estimated success rate of 84% at 18 months. Compared to preoperative parameters, there were significant improvements in median AUA scores, Qmax and PVR. The CAUTI rate per 1000 urinary catheter days was calculated at 12.42. Conclusion: Catheter removal on day seven following VI BMGU is a safe and effective strategy offering durable outcomes while reducing the risks associated with prolonged catheterisation. Larger randomised studies are warranted with a comparison of different surgical techniques.