Urethral stricture accounts for 4–13% of cases of female Bladder outlet obstruction (BOO), presenting with LUTS. In the absence of a definitive diagnostic criterion, this condition is often underdiagnosed. Traditionally, urethral dilatation was the preferred method, but recent studies have shown promising results with female urethroplasty. Augmentation urethroplasty had a mean success rate of 80%- 87%. The mean success rate for oral mucosa grafts ranged from 89% to 94%, with an average follow-up of over 18 months, as per various systematic reviews.

Aims and Objectives: The purpose of this study is to share our institutional experience with the growing body of research. The primary outcome measure was surgical success, defined as the absence of stricture recurrence. The secondary outcome measure was the incidence of de novo urinary symptoms.
Materials and Methods-We performed a retrospective review of patients undergoing female urethroplasty with dorsal(anterior) onlay BMG (Buccal mucosal graft) in our institute between January 2021 & October 2025. The procedure was done as shown in the video. The assessment included the American Urological Association (AUA) symptom score, Uroflowmetry (including peak flow rate, Q max), urethral calibration, ultrasound KUB with post-void residual urine (PVR), Micturition cystourethrogram (MCU), and cystoscopy. Other parameters, such as age, prior interventions, location, stricture length, etiology, postoperative catheter time, complications, and follow-up, were also evaluated.
Statistical analyses were performed using the SPSS software version 23.0. Continuous variables were represented as mean ± standard deviation and range (minimum-maximum), and categorical variables were represented as numbers and percentages. Paired Student’s t-test was used to compare the changes in Q max and PVR values at pre- and postoperative visits. P < 0.05 was considered significant

A total of 8 patients underwent this procedure during the specified time period. Median duration of lower urinary tract symptoms before urethroplasty was 14 years. 87% had undergone previous dilations. At a median follow-up of 12 months (range, 1-56 months), two patients required repeat dilatation, resulting in an overall success rate of 75%, with only one case of de novo urge incontinence.

Dorsal (Anterior) onlay BMG urethroplasty can be offered for the correction of persistent female urethral strictures, as it provides durable results and improves patients' quality of life. However, more prospective studies and larger datasets are required, along with long-term follow-up.

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