Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients

Zhou, Liang; Luo, Deyi; Feng, Shijian; Wei, Xin; Liu, Qi; Lin, Yifei; Jin, Tao; Li, Hong; Wang, Kun‐Jie; Shen, Hong

doi:10.1007/s00345-016-1815-5

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…In the same way, it has been reported that the more difficult the diverticulectomy, in particular due to multiple diverticula, proximal diverticula, and previous urethral surgery, the higher the rate of diverticulum recurrence. 11 Pre-operative assessment of patients with T2 weighted pelvic MRI scanning appears to be the most accurate method of diagnosing UD with high sensitivity, specificity, PPV and NPV of 100%, 83%, 92%, and 100%, respectively, 12 and provides detailed information regarding configuration and location.…”

Section: Discussionmentioning

confidence: 99%

Correlation of MRI features of urethral diverticulum and pre‐ and post‐operative stress urinary incontinence

Seth

Naaseri

Solomon

et al. 2018

Neurourology and Urodynamics

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Aims: The complexity of urethral diverticulectomy depends on location, size, and degree of circumferential involvement. MRI features were examined to predict functional outcome after surgery for urethral diverticulum (UD). Methods: A prospectively acquired database was of all patients who have had surgical excision of UD at a tertiary center since 2004 was reviewed. Particular focus was pre-and post-operative urodynamically proven stress urinary incontinence (USUI), and pre-operative MRI features. MRI parameters included diverticular volume, degree of circumferential involvement around the urethra, distance of the Os of UD to bladder neck and urethral length. Students t-test and Mann-Whitney U-test were used to compare rates of de novo USUI. Results: There were 100 patients (mean age 45.8 yrs), who had excision of UD since 2004, with a minimum follow-up of 10 months (range 10-112 months). Full MRI data was available for 83 patients. Fourteen were of simple configuration (16.8%), 32 were horseshoe (38.6%), and 37 (44.6%) were circumferential. Twenty-five (25%) patients had pre-operative USUI, while 12 (12%) patients developed de novo USUI postexcision. While, the majority of patients with de novo USUI (67%) had >270°c ircumferential involvement of urethra, the pre-operative diverticular volume did not predict the likelihood of USUI developing (P = 0.3). A shorter urethral length was associated with pre-operative USUI. Conclusions: 25% of all patients had pre-op USUI, and diverticular volume and urethral length was significantly smaller in this group. The majority of patients with de novo USUI had complex diverticula configuration with higher baseline circumferential angle around urethra, with 67% of angle's between 270 and 360°K E Y W O R D S MRI, stress urinary incontinence, urethral diverticulum 1 | INTRODUCTION Urethral diverticulum (UD) in women are commonly overlooked and misdiagnosed. Up to 6% of women may develop a UD 1 and they are the cause of up to 40% of unexplained lower urinary tract symptoms (LUTS) in women 1,2 including

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Section: Discussionmentioning

confidence: 99%

Correlation of MRI features of urethral diverticulum and pre‐ and post‐operative stress urinary incontinence

Seth

Naaseri

Solomon

et al. 2018

Neurourology and Urodynamics

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“…However, in our study, only eight subjects required reoperation. According to our previous study, women with multiple and proximal diverticula could be at an increased risk of recurrence (9). In our study, these two factors were examined after surgery.…”

Section: Discussionmentioning

confidence: 94%

“…The participant's clinical characteristics were collected and recorded. Fellowship-trained urologists at our institution performed all urethral diverticulectomies in a standard manner, as previously described (9). The steps of this procedure include careful dissection, complete excision and watertight three-layer closure without tension (10).…”

Section: Methodsmentioning

confidence: 99%

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Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women

Sun

Tang

et al. 2019

Int. braz j urol.

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Introduction and Objective: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD. Materials and Methods: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. Results: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no signifi cant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. Conclusion: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.

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“…There are several known postoperative complications reported in the literature including urethral stricture, ureterovaginal fistula, stress incontinence, and recurrent UTIs [ 14 ]. The risk of complications increases with repeat procedures [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

A Case of Urethral Diverticulum with Surgical Repair Using Cadaveric Pericardial Tissue

Custer

Jessop

Zaslau

et al. 2018

Case Reports in Urology

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A urethral diverticulum is a relatively uncommon finding. The estimated prevalence is approximately 1-5% in the general population. While the definitive treatment is surgical correction, there are limited studies guiding the best approach to repair. This is the case of a 48-year-old female who initially presented with vaginal discharge, dysuria, and dyspareunia. MRI revealed the diagnosis of suspected urethral diverticulum. The patient was treated with surgical correction with the aid of needle localization prior to the procedure. After the diverticulum was excised, the resulting defect in the urethra was successfully closed with cadaveric pericardial tissue. A urethral diverticulum should be considered in the differential diagnosis when a patient presents with symptoms such as recurrent urinary tract infections (UTIs) vaginal mass, dysuria, dyspareunia, or vaginal discharge. The use of cadaveric tissue augments the surgical technique for repair.

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Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients

Abstract: The surgical outcomes of urethral diverticulectomies were acceptable. Multiple diverticula, proximal diverticula and previous urethral surgery were three independent risk factors for recurrent diverticula.

Cited by 14 publications

References 18 publications

Correlation of MRI features of urethral diverticulum and pre‐ and post‐operative stress urinary incontinence

Correlation of MRI features of urethral diverticulum and pre‐ and post‐operative stress urinary incontinence

Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women

A Case of Urethral Diverticulum with Surgical Repair Using Cadaveric Pericardial Tissue

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