Minimally invasive surgical treatment of female hypospadias and urethral hypermobility complicated by postcoital dysuria

Introduction. Currently, a large number of different surgical methods have been developed for the treatment postcoital dysuria caused by hypospadias and urethral hypermobility. However, literature does not reflect clear criteria indications particular method. Various modifications traditional transposition can be accompanied traumatic injury to abundantly innervated paraclittoral paraurethral zones, which provokes sexual disorders, up anorgasmia. The search continues new, effective, but less invasive techniques compared transposition. Purpose study. To assess efficacy safety combined technique: removal urethra-hymenal adhesions along with injection gel filler. Materials . 83 patients hypermobility complicated were treated since 2015. age ranged from 17 40 years. Examination revealed urethro-hymenal varying severity positive O’Donnell-Hirschhorn test in all women. One patient had previously undergone temporary effect. All women underwent treatment, consisted suburethral hyaluronic acid-based bulking (1-2 ml) was injected fan-shaped manner paraurethrally point at 6 o'clock conventional dial. Thus, «gel pad» created, lifts meatus distal urethra, limiting their mobility traumatization during intercourse. No complications observed. postoperative examination performed after 1, 6, 12 months. Results. An improvement quality life noted 74 (89%) (UDI PISQ-12 questionnaires). external orifice displaced inwards, urethra projected above vaginal entrance test. In 13 (15.5%) patients, biodegradation return symptoms various degrees terms operation (from 8 months). required repeat injections filler; four needed 2 1 three injections. repeated manipulations under local anaesthesia. cases (9.6%), continued urination disorders despite termination dominance dysuria, additional complex treatment. Improvement observed 89% operated according described technique. Urethral any patients. Conclusions. technique improves treatment's results female minimal development risk complications. disadvantage is natural biodegradation, may necessitate its reimplantation.