Indian Journal of Urology
: 2021  |  Volume : 37  |  Issue : 3  |  Page : 300--301

Female bladder outlet obstruction and urethral reconstruction

Pankaj Joshi 
 Kulkarni Reconstructive Urology Center, Pune, Maharashtra, India

Correspondence Address:
Pankaj Joshi
Kulkarni Reconstructive Urology Center, Pune, Maharashtra

How to cite this article:
Joshi P. Female bladder outlet obstruction and urethral reconstruction.Indian J Urol 2021;37:300-301

How to cite this URL:
Joshi P. Female bladder outlet obstruction and urethral reconstruction. Indian J Urol [serial online] 2021 [cited 2023 Jan 27 ];37:300-301
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Editors : Nikhil Khattar, Rishi Nayyar, Arabind Panda

Year : 2020

Publisher : Springer Nature Singapore Pte Ltd. 2021

Pages : 221

ISBN : 978-981-15-8521-0 (eBook)

It gives me immense pleasure to review this book edited by my colleagues. The majority of our practice is about male urology, where our knowledge is more focused. Female voiding dysfunction has not received as much representation in the textbooks. The editors and the team of authors have done a marvelous job compiling the entire female voiding dysfunction including reconstruction in about 220 pages. For those interested in this topic, this book represents a valuable resource to treat female voiding dysfunction.

The chapters cover the various areas completely. Hypocontractile bladder or underactive detrusor often gets labeled easily. This chapter highlights the three types of voiding pattern which is useful in clinical practice. In the next chapter, the author has emphasized the use of uroflowmetry, urodynamics (UDS), and use of 0° lens in evaluating the urethra to diagnose the type of voiding dysfunction. The authors also discuss controversies in the diagnosis of bladder outlet obstruction (BOO) based on UDS. Primary bladder neck obstruction in females is the second most common cause of BOO. The authors have magnificently described an effective video UDS to diagnose the condition. We all have performed bladder neck incisions (BNI) in men. But it is important to know that BNI can equally be effective in females correctly diagnosed with BOO. I commend the authors for this chapter on primary bladder neck obstruction.

In managing female voiding dysfunction, Fowler's syndrome is important. The chapter discusses the methods to diagnose it and treatment with intraurethral injection of botulinum toxin and sacral neuromodulation. I also believe that the table for differential diagnoses is very useful for the readers. Prolapse of pelvic organs is often neglected as a cause of voiding dysfunction. It is an easy diagnosis by clinical examination. The authors have carefully complied the chapter on prolapse and the management modalities. As simple as a pessary can make a patient happy, surgery always remains the curative option.

Summarizing the chapters, compiling the vast information, and then applying it correctly to clinical practice is made easy with guidelines and algorithms. The editors have done an excellent job, providing a working algorithm for evaluation of female lower urinary tract symptoms (LUTS). The discussion on pharmacotherapy is extensive. Medicines will work perfectly if the diagnosis is correct. The author has given his management algorithm and the appropriate formula to use alpha-blockers, botulinum, and relaxants in managing the condition.

The second half of the book is about female urethral strictures. Women with stricture frequently undergo repeated dilatations or intermittent catheterization. Both are uncomfortable situations. The fear of causing incontinence after urethroplasty has led to a very slow establishment of urethroplasty as a management option. I appreciate the authors in boldly stating the fact that success of almost 90% can be achieved with a single urethroplasty. The authors have scientifically written the chapter, highlighting the need for urethroplasty in female strictures.

Knowing anatomy and physiology makes surgical craft easy. The chapter on applied anatomy is one of the best chapters of the book. I should congratulate the author for making his own illustrations. The book has excellent surgical photographs of operative steps and illustrations of the surgical technique of urethroplasty. What's good to read is that the majority of series come from Indian surgeons and this shows our commitment to academics and female urology. I am personally happy to see a reference being made to the technique of double-face urethroplasty in obliterative female strictures. Various authors have contributed to the surgical craft, approach, and technical details about the ways of urethroplasty. The chapter on flaps is comprehensive.

The book concludes with a rare but important topic of posterior female urethral injuries. The chapter is written to the point and will give readers a glimpse of this complex injury.

I still have my reservations on the nomenclature about female urethra. The true nomenclature of female urethra should be anterior and posterior wall rather than dorsal and ventral wall. I hope the editors will discuss about this in the subsequent edition so we can have a standard nomenclature.

I believe the book is worth the price and I would recommend having it in the bookshelf. The book will be handy as a guide to manage female LUTS as well as female urethral strictures. My best wishes to the editors; they have got good contributions from authors of individual chapters. I wish them success for this endeavor and many more.