Female urethral stricture is a rare condition 
Distal stricture have usually been managed using meatoplasty. Advancement urethroplasty might be an interesting surgical alternative to meatoplasty.

We present  the case of a 79 year-old female. 
She reported voiding symptoms for several years  : slow stream, hesitancy and straining to void. On physical examination a narrowing of the urethral meatus is noted
The cystoscopy was not possible during the visit because of the stricture, the stricture could only be catheterized with a 12 Fr urethral dilator
We offered to do a distal urethrectomy and advancement urethroplasty.

The stricture is easily identified on physical examination. Two holding stiches are place within the urethral lumen.
An incision is made just above the dorsal aspect of the urethral meatus
The dorsal urethra is then opened longitudinally until healthy tissue is found above the stricture. Here the stricture is about one centimeter long. To confirm that the incision has reached healthy urethral tissue, an urethro-cystoscopy Is performed.
Before further pursuing the incision, the healthy urethra is sutured to the vaginal aspect of the incision at 12 o’clock to start the advancement urethroplasty using 5/0 pds. 
The incision is then carried out to the ventral circumference of the urethral meatus. 
The distal urethrectomy is completed, making sure to remove all the thickened fibrotic tissue. Additional stitches are placed all around the new urethral meatus to complete the advancement urethroplasty 
An indwelling 16F urethral catheter is placed at the end of the procedure. 

The operative time was 30 minutes with minimal blood loss. There was no postoperative complications. The patient was discharged on postoperative day 2 and the urethral catheter on day 8. The patient resumed spontaneous voiding and was completely relieved of her voiding symptoms. She did not experience stress urinary incontinence postoperatively.

Distal urethrectomy with advancement urethroplasty is safe and feasible in female patients with relatively short (up to 1 cm long) stricture of the distal urethra.