Simple vs Complex Urethral Diverticulum: Presentation and Outcomes

Patient Characteristics and Perioperative Outcomes of Female Urethral Diverticulectomy: Analysis of a Multi-Institutional Prospective Database

“…17 Hemorrhage can also occur intraoperatively, but this complication is rare, with only one patient in our database requiring a blood transfusion in the postoperative period (1/122, 0.82%). Urethral diverticulectomy has also been reported in the literature to cause urethral injury, but this complication was not identified within our database.…”

Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: A selective approach

“…Those authors who favor concomitant repair have suggested that the use of autologous fascia at the time of repair not only treats the UI, but also acts as an interposition graft buttressing the repair, as well as potentially reducing the need for a second separate incontinence procedure. This could be an argument for a “prophylactic” sling at the time of TVUD . However, there are inherent risks and potential increased morbidity (urinary retention, obstruction, etc), convalescence time and cost associated with SUI repair which may mitigate against concomitant anti‐incontinence surgery in all patients.…”

“…There is no consensus on appropriate timing of surgical management of UD and SUI, and some surgeons favor a staged procedure, while others recommend simultaneous treatment of stress urinary incontinence with an autologos pubovaginal fascial sling (APVS). Concomitant APVS placement has been found to be safe and effective for treating stress urinary incontinence at the time of urethral diverticulectomy . However, APVS is an invasive procedure which requires additional operative time, and is associated with the potential for additional complications such as de novo voiding dysfunction, urinary retention as well fascial harvest site problems.…”

“…Concomitant APVS placement has been found to be safe and effective for treating stress urinary incontinence at the time of urethral diverticulectomy. 9,12 However, APVS is an invasive procedure which requires additional operative time, and is associated with the potential for additional complications such as de novo voiding dysfunction, urinary retention as well fascial harvest site problems. While the concomitant use of a minimally invasive midurethral synthetic mesh sling at time of urethral diverticulectomy may mitigate some of these considerations, and a single small case series has reported the successful use of this modality, 13 the AUA guidelines recommend against the use of synthetic materials in the setting of UD due to the potential risk of erosion of the synthetic graft into the urethra.…”

How and why to take a Martius labial interposition flap in female urology

“…To improve healing and reduce fistulae or recurrence in urethral diverticulectomy (4,5), urethral mesh excision (4,6), vaginal repair of urethrovaginal (6) and vesicovaginal fistulae (6-8), and bladder neck closure for urethral erosion (9);…”