1554 Female Urethral Diverticula Evaluation of Voiding Dysfunction Before and After Surgery

Wilson, Ailsa; Hussain, Muddassar; Hamid, Rizwan; Ockrim, Jeremy; Shah, Julian; Greenwell, Tamsin

doi:10.1016/j.juro.2012.02.1324

Cited by 2 publications

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“…Although some patients may count postvoid dribbling caused by the emptying of the diverticulum as incontinence, studies have reported that true concomitant SUI is found in up to approximately 50% of UD patients [25,40]. Since pre-existing SUI may disappear after surgical diverticulectomy in 50%-100% of patients [41], a urodynamic study should be performed before urethral diverticulectomy to decide whether concomitant antiincontinence surgery is necessary to facilitate patient counseling regarding the treatment plan. An important decision that should be made before urethral diverticulectomy in UD patients with SUI is whether to perform anti-incontinence surgery concurrently or to delay the procedure until the confirmation of persistent SUI postoperatively.…”

Section: Management Of Ud With Concomitant Suimentioning

confidence: 99%

Pathophysiology and Management of Long-term Complications After Transvaginal Urethral Diverticulectomy

2021

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Female urethral diverticulum (UD) is a rare and benign condition that presents as an epithelium-lined outpouching of the urethra. It has various symptoms, of which incontinence in the form of postmicturition dribble is the most common. The gold standard for the diagnosis of UD is magnetic resonance imaging, and the treatment of choice is transvaginal diverticulectomy. Despite the high success rate of transvaginal diverticulectomy, postoperative complications such as de novo stress urinary incontinence (SUI), recurrence, urethrovaginal fistula, recurrent urinary tract infections, newly-onset urgency, and urethral stricture can occur. De novo SUI is thought to result from weakening of the anatomical support of the urethra and bladder neck or damage to the urethral sphincter mechanism during diverticulectomy. It can be managed conservatively or may require surgical treatment such as a pubovaginal sling, Burch colposuspension, or urethral bulking agent injection. Concomitant SUI can be managed by concurrent or staged anti-incontinence surgery. Recurrent UD may be a newly formed diverticulum or the result of a remnant diverticulum from the previous diverticulectomy. In cases of recurrent UD requiring surgical repair, placing a rectus fascia pubovaginal sling may be an effective method to improve the surgical outcome. Urethrovaginal fistula is a rare, but devastating complication after urethral diverticulectomy; applying a Martius flap during fistula repair may improve the likelihood of a successful result. Malignancies in UD are rarely reported, and anterior pelvic exenteration is the recommended management in such cases.

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Section: Management Of Ud With Concomitant Suimentioning

confidence: 99%

Pathophysiology and Management of Long-term Complications After Transvaginal Urethral Diverticulectomy

2021

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“…Concomitant SUI is one of the most frequently reported symptoms, occurring in approximately 10-57% of patients with UD [5,[12][13][14]. Since SUI may disappear after urethral diverticulectomy in 50-100% of patients [15], clinicians are often ambivalent about their decision on whether to perform a concurrent anti-incontinence surgery or not [16]. Studies report that concurrent anti-incontinence surgery may have an advantage in preventing the need for a subsequent anti-incontinence procedure [7].…”

Section: Discussionmentioning

confidence: 99%

An Eight-Year Experience of Transvaginal Urethral Diverticulectomy: A Single-Center Study

Kim

Lee

Park

et al. 2022

Urogenit Tract Infect

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Purpose: This study aimed to analyze and report the surgical outcomes in female patients with urethral diverticulum (UD) over an eight-year period at a single center. Materials and Methods: Data of 49 UD females who underwent transvaginal urethral diverticulectomy between October 2011 and December 2019 were collected. The characterization of UD was reviewed using pelvic imaging studies. The pre-and post-operative symptoms, post-operative complications, and pathological findings were analyzed by reviewing the medical records. Results: The most frequent pre-operative symptom was dysuria (n=18), followed by incontinence (n=14), and these symptoms persisted until 3 months post-operatively in one and six patients, respectively. Pre-operative incontinence was cured in eight patients; however, de novo stress urinary incontinence occurred in five patients within a month after surgery. Submucosal macroplastique injection was administered to these patients; of whom, one was cured and three showed an improvement. Recurrent UD was found in seven patients at a mean of 14.14±17.21 months post-operatively, and a repeat diverticulectomy was performed in six of them; of these, one recurred again and was cured after the third diverticulectomy. Urethral strictures were observed in two patients within a month after the operation but improved after urethral dilatation. Bleeding and surgical site infections were observed in one and two patients, respectively, but were successfully managed conservatively. According to the pathological report, only one was diagnosed with urethral adenocarcinoma. Conclusions: Transvaginal urethral diverticulectomy can effectively manage UD, and its post-operative complications can be successfully managed by a proper treatment.

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1554 Female Urethral Diverticula Evaluation of Voiding Dysfunction Before and After Surgery

Cited by 2 publications

References 0 publications

Pathophysiology and Management of Long-term Complications After Transvaginal Urethral Diverticulectomy

Pathophysiology and Management of Long-term Complications After Transvaginal Urethral Diverticulectomy

An Eight-Year Experience of Transvaginal Urethral Diverticulectomy: A Single-Center Study

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