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

Raup, Valary T.; Hess, Deborah; Hanske, Julian; Schmid, Marianne; Varda, Briony K.; Das, Anupam; Trinh, Quoc‐Dien; Eswara, Jairam R.

doi:10.1016/j.urology.2015.07.007

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…In prior studies, the most common presenting symptoms include vaginal mass, irritative urinary symptoms, and UTIs, which was consistent with the presenting concerns of the patients in our cohort. 2,3 It should be noted that very few women (5%) present with the classic triad of postvoid dribbling, dysuria, and dyspareunia. 1,2,4 As such, special attention should be focused on a complete medical history as it pertains to genitourinary symptoms because diverticula can often be associated with nonspecific concerns, and the diagnosis can often go overlooked.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Urethral Diverticula in Women

Vaidya

Olson

Wolter

et al. 2021

Female Pelvic Med Reconstr Surg

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Objective: Urethral diverticulum is a rare, yet important condition for the female pelvic surgeon. We aimed to characterize the women who have been seen for this condition across the three Mayo Clinic locations.Methods: Medical record review was performed for patients across all three Mayo Clinic sites (Rochester, Arizona, Florida) that had International Classification of Diseases, Ninth Revision, (ICD-9) and International Classification of Diseases, Tenth Revision, (ICD-10) codes corresponding to urethral diverticulum (ICD-9, 599.2; ICD-10, N36.1). We also performed a review of patients who underwent urethral diverticulectomy via Current Procedural Terminology (CPT) code 53235. Data were available for patients from June 1, 2003, to October 5, 2018. Patients were classified by age, etiology, presenting symptomatology, location, treatment, pathology, and postoperative outcomes.Results: Four hundred forty-seven women met initial coding criteria for urethral diverticula, with 228 women having documented urethral diverticula. The most common presentations were irritative voiding symptoms (93) and infections (92). The most common diagnostic modality was radiographic imaging (198/228) with magnetic resonance imaging accounting for 157 cases. Etiology was unknown in the majority of cases (181/228). Of women who were diagnosed, 172 underwent diverticulectomy with 51 concurrent urethral sling placements. Final pathology demonstrated 2 cases of malignancy. Postoperative follow-up ranged from 0 months to 15 years (mean, 1.4 years; median, 4 months). Forty-three patients had persistent urinary symptoms after diverticulectomy with stress incontinence being the most common. Eight patients underwent subsequent sling placement. Fourteen patients had recurrence.Conclusions: This appears to be the largest reported series on female urethral diverticula, a rare yet important entity that requires special consideration. Most surgical cases found resolution of symptoms after diverticulectomy. Importantly, less than 2% of urethral diverticula were associated with malignancy.

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Section: Discussionmentioning

confidence: 99%

Characterization of Urethral Diverticula in Women

Vaidya

Olson

Wolter

et al. 2021

Female Pelvic Med Reconstr Surg

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“…Whether stress incontinence should be treated at the time of the diverticulectomy or in a delayed procedure is an interesting question, as SUI can be due to the UD and/or be a complication of the UD repair itself. Interestingly, the patient had a history of UV fistula, which is also a potential complication of UD repair (8). The risks of the procedure must be carefully weighed against the patient's symptoms and current quality of life.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Urethral Diverticulum: A Case Report

Lilly¹,

Richter²

2019

jus

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Recurrence of urethral diverticulum after surgical repair is common and well established in the literature. However, data on the rates of multiple recurrences in the same patient is lacking. Here, we present the case of a 42-year-old female patient with a history of multiple urethral diverticula, who presented with a urethral diverticulum containing a large calculus. Our aim was to review the risk factors and management of patients who present with recurrent urethral diverticula.

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“…Although urethral diverticulectomy is a rare procedure, it is reportedly being performed more frequently ( 7 ). Patients are usually diagnosed with UD based on typical symptoms, including a vaginal wall mass, dysuria, postvoid dribbling, and dyspareunia, although this condition has a wide range of presentations ( 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although a wide range of treatments for UD have been described, surgical excision is generally recognized as the standard therapy, with reported cure rates from 70-97% ( 2 - 6 ). In the literature, many postoperative complications have been reported, including UTI, superficial wound infection, stress urinary incontinence (SUI), UD recurrence, urinary fistula, and urethral stricture ( 7 ). In addition, certain reviews have reported reoperation rates as high as 10.7% ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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

Cited by 8 publications

References 19 publications

Characterization of Urethral Diverticula in Women

Characterization of Urethral Diverticula in Women

Recurrent Urethral Diverticulum: A Case Report

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

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