A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes

Ockrim, Jeremy; Allen, D.; Shah, Priya; Greenwell, Tamsin

doi:10.1111/j.1464-410x.2009.08348.x

Cited by 89 publications

(79 citation statements)

References 18 publications

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“…1b). VCUG achieves accurate diagnosis in 67-95 % of cases [19][20][21]. Filling defects noted on the study should raise suspicion for diverticular stone or malignancy.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

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Female Urethral Diverticulum: Current Diagnosis and Management

Crescenze

Goldman

2015

Curr Urol Rep

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While urethral diverticulum (UD) affects less than 20 per 1,000,000 women overall, it is thought to represent 1.4% of women with incontinence presenting to urology practices. It is hypothesized to evolve from periurethral glands that become obstructed, infected, and dilated over time, and patients typically present with dyspareunia, bothersome lower urinary tract symptoms (LUTS), and/or recurrent UTIs. In many patients, a periurethral mass can be appreciated on exam. In recent years, magnetic resonance imaging (MRI) has become the imaging test of choice for diagnosis of UD, but ultrasound (US) is a readily available alternative and provides good specificity at a lower cost. Surgical excision of the diverticulum with tension-free, water-tight, three-layer closure continues to be the mainstay of treatment of UD with most studies reporting cure rates of >90%. Concomitant treatment of preexisting stress incontinence with autologous fascial pubovaginal sling can be used at the time of diverticulectomy to avoid a secondary procedure. However, since secondary anti-incontinence procedures are needed in only a small number of patients, up-front stress incontinence treatment may result in significant overtreatment, and staged anti-incontinence procedures continue to be a reasonable option for patients with persistent bothersome stress urinary incontinence (SUI) after diverticulectomy.

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“…1b). VCUG achieves accurate diagnosis in 67-95 % of cases [19][20][21]. Filling defects noted on the study should raise suspicion for diverticular stone or malignancy.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

“…At the time of presentation, about 10-57 % [14,16,19,21] of patients with UD complain of concomitant incontinence. While some patients may have post-void dribbling associated with emptying of the diverticulum, true stress incontinence has been confirmed in up to 50 % of patients in some series [19, 37•].…”

Section: Anti-incontinence Proceduresmentioning

confidence: 99%

Female Urethral Diverticulum: Current Diagnosis and Management

Crescenze

Goldman

2015

Curr Urol Rep

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“…RCUG also makes it possible to look for other congenital malformations that may associate with the urethral diverticulum. These malformations are hypospadias, the valves of the posterior urethra [12].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in the case of a large collar and urethra of poor quality, some authors propose a flattening and the urethral reconstitution will be done in the second time after 3 to 6 months [9]. The treatment of the diverticulum of the posterior urethra is based on perineal or pre pubic diverticulum resection [7]- [12]. Some authors advocate for asymptomatic forms that the treatment is based on the manual pressure of the urethra at the level of the diverticulum at the end of urination and the use of periodic antibiotic prophylaxis to prevent infections [12].…”

Section: Discussionmentioning

confidence: 99%

Congenital Urethral Diverticulum in Male Subject: Report of Three Cases

Sow¹,

Sine²,

Diamé³

et al. 2018

OJU

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Introduction: The urethral diverticulum or urethrocele corresponds to a saccular dilation of a portion of the urethral wall. Our objective was to report the clinical aspects, investigations and therapeutic aspects of three cases of congenital urethrocele. Observations: They were three male patients aged 11, 20 and 42 years, two of whom had consulted for terminal dribbling. The diagnosis of urethrocele was made for all patients with retrograde and voiding cystouretrography. Treatment consisted of resection of the urethrocele followed by urethroplasty for both cases. Conclusion: Diagnostic of congenital urethrocele must always be assessed when there is a persistent terminal dribbling, and systematically ask for a Retrograde Cysto-Urethrography (RCUG) to confirm it.

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“…The most useful imaging modality for UDs is MRI (2). MRI plays an important role in the diagnosis of UDs and ideally provides the surgeon with preoperative information regarding location, number, size, configuration, and communication of the UDs.…”

mentioning

confidence: 99%

Female urethral diverticulum

Wang

Liu

et al. 2013

Int. braz j urol.

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_______________________________________________________________________________A 36-year-old woman presented to our department with a 6-week history of dysuria, urinary frequency and refractory urinary tract infection. Physical examinations revealed a tender cystic mass in the anterior vaginal wall. Laboratory test showed the following: leukocyte count, 13610 /mm A UD is a focal outpouching of the urethra and usually occurs in women in the 3rd-7th decade of life, with an estimated prevalence of 0.6-6% (1). The vast majority of UDs are from acquired causes, with the most widely accepted theory involving rupture of a chronically obstructed and infected periurethral gland into the urethral lumen. Risk factors for acquired UDs include repeated infection of the periurethral glands, vaginal birth trauma, trauma from the prior vaginal or urethral procedures (1).The classic presentation of UD has been described historically as the "three Ds": dysuria, dyspareunia, and dribbling (post-void). The most useful imaging modality for UDs is MRI (2). MRI plays an important role in the diagnosis of UDs and ideally provides the surgeon with preoperative information regarding location, number, size, configuration, and communication of the UDs. Although MRI is the best preoperative diagnostic tool for evaluating the UDs, the old standby double balloon pressure urethrography (adding sky-blue or brilliant green as staining agent) is of great value of intraoperative identification of these compound diverticular sacks and facilitating their resection (3).Complications associated with UDs include recurrent infection, urinary incontinence, calculus formation, and development of intradiverticular neoplasm. Clinicians should be aware of the possibility of a UD in women with unexplained

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A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes

Cited by 89 publications

References 18 publications

Female Urethral Diverticulum: Current Diagnosis and Management

Female Urethral Diverticulum: Current Diagnosis and Management

Congenital Urethral Diverticulum in Male Subject: Report of Three Cases

Female urethral diverticulum

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