Management of the Devastated Female Urethra

Purpose of Review: Critical evaluation of literature published in last 5 years pertaining to management of the devastated urethra in female patients. Recent Findings: The devastated female urethra is a debilitating heterogenous disease that can be extremely difficult to manage. The recent published literature has largely been retrospective in nature but has shown good long-term outcomes for multiple operative approaches. Summary: Female patients with incontinence due to devastation of the urethra pose a challenge due to limited surgical options. To achieve dryness, all patients will require closure of the bladder outlet, whether a permanent surgical closure, a functional closure, or cystectomy. If urinary diversion is required, it can be accomplished either through placement of a suprapubic tube, creation of an ileovesicostomy, creation of a catheterizable channel (i.e., Mitrofanoff procedure), or complete diversion with an ileal conduit.