Experience with the Management of Urethral Diverticulum in 63 Women

Ganabathi, K.; Leach, Gary E.; Zimmern, Philippe E.; Dmochowski, Roger R.

doi:10.1016/s0022-5347(17)32442-4

Cited by 137 publications

(105 citation statements)

References 31 publications

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“…68 Two recurrences One fistula [33] Swierzewski and McGuire (1993) [15]. Overall, 29 (95%) patients were cured of their diverticulum.…”

Section: Results Of Diverticulectomymentioning

confidence: 99%

“…Fistula occurred in three (7.7%) out of the 39 patients of diverticulectomies in one series [61], and de novo SUI developed in four (16%) patients postoperatively in another [17]. In an older publication, there were two cases of diverticulum recurrence and one of urethro vaginal fistula in 68 patients [33]. Delayed diagnosis, large size and complex configuration are associated with a higher rate of complications [62].…”

Section: Results Of Diverticulectomymentioning

confidence: 99%

“…Bladder neck suspension has also been performed concomitantly with diverticulectomy in women with incontinence, and results have also been satisfactory [33,64].…”

Section: Results Of Diverticulectomymentioning

confidence: 99%

“…Eight (57%) of these patients had symptoms of SUI (urodynamically confirmed in seven) and two had postvoid dribbling. In another series of 63 women, incontinence was the only presenting complaint in 31.7% of patients, and genuine SUI was found in 28 (48.3%) out of 58 patients who were urodynamically evaluated [33].…”

Section: Clinical Presentationmentioning

confidence: 91%

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Female urethral diverticula: from pathogenesis to management. An update

Giannitsas

Athanasopoulos²

2010

Expert Review of Obstetrics & Gynecology

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Urethral diverticulum, a sac-like protrusion communicating with the urethral lumen, is a relatively uncommon occurrence. It represents either an infected paraurethral gland that has ruptured in the urethra or a prolapse of the urethral wall through a defect in the periurethral fascia. The classic clinical presentation is a soft, slightly tender vaginal lesion causing dysuria, dyspareunia and dribbling incontinence. Unfortunately, this classic presentation is only seldom seen. The condition may be either asymptomatic or manifest nonspecific symptoms of any lower genitourinary tract pathology. In the majority of cases, diagnosis relies on imaging, with MRI becoming the technique of choice, as it is accurate and provides detailed anatomical information. Complete excision of the diverticular sac with meticulous urethral and periurethral reconstruction is the 'gold standard' treatment. Success rates of 70-100% have been reported, with a few complications occurring, particularly in cases of large and complex diverticula.

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“…68 Two recurrences One fistula [33] Swierzewski and McGuire (1993) [15]. Overall, 29 (95%) patients were cured of their diverticulum.…”

Section: Results Of Diverticulectomymentioning

confidence: 99%

Section: Results Of Diverticulectomymentioning

confidence: 99%

“…Bladder neck suspension has also been performed concomitantly with diverticulectomy in women with incontinence, and results have also been satisfactory [33,64].…”

Section: Results Of Diverticulectomymentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 91%

See 2 more Smart Citations

Female urethral diverticula: from pathogenesis to management. An update

Giannitsas

Athanasopoulos²

2010

Expert Review of Obstetrics & Gynecology

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“…urethral diverticulum, urethral stricture and urethral masses). 7,8 Also, we did not consider patients with post-void dribbling as having II.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic findings in women with insensible incontinence

et al. 2012

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Abbreviations & AcronymsObjectives: To define the urodynamic study findings among women with insensible urinary incontinence. Methods: Women complaining of insensible incontinence who underwent urodynamics at our center were identified. Coexisting symptoms of stress incontinence, urgency incontinence and/or mixed incontinence were recorded. The primary outcome was the urodynamic study finding. Urodynamic stress incontinence, detrusor overactivity incontinence, combination of both or neither (no incontinence) were the possible diagnoses. Results: A total of 58% of patients had insensible incontinence alone and 42% had insensible incontinence combined with other urinary incontinence symptoms. Of the patients with insensible incontinence alone, 37% had no incontinence on urodynamics, whereas urodynamic stress incontinence was diagnosed in 52%. Isolated urodynamic stress incontinence was found in 73% of patients with insensible and stress incontinence symptoms. In patients with insensible plus urgency incontinence, isolated detrusor overactivity incontinence and detrusor overactivity incontinence with urodynamic stress incontinence were found in the same percentage of women (40% each). In patients with symptoms including stress urinary incontinence, stress incontinence was the predominant urodynamic finding. Conclusions:In patients who have incontinence symptoms in addition to insensible incontinence, these symptoms are highly predictive of urodynamic findings. In particular, women with insensible incontinence, concomitant stress incontinence symptoms are most predictive of urodynamic findings (i.e. urodynamic stress urinary incontinence). In contrast, where insensible incontinence represents the only symptom, urodynamic findings vary widely, with a significant proportion having non-diagnostic studies.

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