Suburethral Diverticula Treated by Marsupialization

Lichtman, Allan S.; Robertson, Jack R.

doi:10.1097/00006254-197608000-00022

Cited by 8 publications

(4 citation statements)

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“…Alternative less invasive treatments that have been reported in small case series include fulguration, marsupialisation, and endoscopic de‐roofing. Lichtman and Robertson described complete resolution of symptoms in all eight patients treated with marsupialisation, although outcomes at medium‐ and long‐term follow‐up were not reported. In a larger study of 57 women, 40 of whom underwent treatment with Spence marsupialisation, good outcomes were reported for symptomatic resolution with a low rate of complications .…”

Section: Discussionmentioning

confidence: 97%

Urethral diverticulectomy with Martius labial fat pad interposition improves symptom resolution and reduces recurrence

et al. 2016

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ObjectiveTo assess the presenting features and medium-term symptomatic outcomes in women having excision of urethral diverticulum with Martius labial fat pad (MLFP) interposition. Patients and MethodsWe reviewed our prospective database of all female patients having excision of a symptomatic urethral diverticulum between 2007 and 2015. Data on demographics, presenting symptoms and clinical features were collected, as well as postoperative outcomes. ResultsIn all, 70 women with a mean (range) age of 46.5 (24-77) years underwent excision of urethral diverticulum with MLFP interposition. The commonest presenting symptoms were a urethral mass (69%), urethral pain (61%), and dysuria (57%). Pre-existing stress urinary incontinence (SUI) was present in 41% (29) of the women. After surgery, at a mean (SD) of 18.9 (16.4) months follow-up (median 14 months), complete excision of urethral diverticulum was achieved in all the women, with resolution of urethral mass, dysuria and dyspareunia in all, and urethral pain in 81%. Immediately after surgery, 10 (24%) patients reported de novo SUI, which resolved with time and pelvic floor muscle training such that at 12 months only five (12%) reported continued SUI. There was one symptomatic diverticulum recurrence (1.4%). ConclusionsThe commonest presenting symptom of a female urethral diverticulum is urethral pain followed by dysuria and dyspareunia. Surgical excision with MLFP interposition results in complete resolution of symptoms in most women. The incidence of persistent de novo SUI in an expert highvolume centre is 12%. Keywordsfemale lower urinary tract symptoms, urethral diverticula, urethral diverticulectomy, urinary incontinence

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Section: Discussionmentioning

confidence: 97%

Urethral diverticulectomy with Martius labial fat pad interposition improves symptom resolution and reduces recurrence

et al. 2016

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“…Surgery of the urethra may cause bladder injury, fistula formation, lesions of the bladder neck, sphincter damage and urethral strictures. Furthermore, the recurrence rate of the diverticula following excision is up to 18%-20% [4,5].…”

Section: Discussionmentioning

confidence: 99%

Transurethral laser lithotropsy in a female urethral diverticulum containing stones

Nøhr

Walter

1995

Int Urogynecol J

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“…Asymptomatic microdiverticula may be operative stress incontinence, the surgical technique is treated without major surgery (e.g. incision of the neck, important; 15% of stress incontinence is caused by calibration of the orifice, or post-voiding digital decommarsupialization [26]. Using the present excision techpression [19][20][21]).…”

Section: Methodsmentioning

confidence: 99%

Diverticula of the female urethra

Fortunato

Schettini

Gallucci

1997

British Journal of Urology

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Objective To determine the optimum procedure for the diagnosis and therapy of diverticula of the female urethra. Patients and methods The study included 18 patients with urethral diverticula treated at the Cristo Re Hospital in Rome between 1987 and 1995. Most of the patients were suffering from cystitis (eight), dysuria (seven) and recurring urinary infections (11). Less frequently, more specific symptoms were present such as post‐voiding dribbling (two) and anterior vaginal mass (three). The pre‐operative evaluation included a history, physical examination, voiding and positive pressure voiding cysto‐urethrography (VCUG) and urodynamic tests. A ‘typical’ surgical excision of the diverticula was carried out in all cases. Surgical excision was combined with cystopexis (Raz operation) in four patients with urinary stress incontinence and three with detrusor instability were treated post‐operatively with anticholinergics for 3 months. The outcome was evaluated by a physical examination and urodynamic tests at 3, 6 and 12 months post‐operatively; the mean (range) follow‐up was 34 (2–80) months. Results All the urethral diverticula were in the distal two‐thirds of the urethra, along the posterolateral wall. The VCUG was sufficient for diagnosis in eight patients while the other 10 required a positive‐pressure VCUG. Fifteen patients were evaluated; complications included a urinary tract infection for 2 months in four patients and stress incontinence for 2 months in two. There were no recurrences or urethrovaginal fistulae. Conclusions Diverticula in the female urethra are difficult to diagnose because the symptoms can be misleading; the positive‐pressure VCUG is useful in doubtful cases. However, a detailed history and physical examination are mandatory.

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Suburethral Diverticula Treated by Marsupialization

Cited by 8 publications

References 0 publications

Urethral diverticulectomy with Martius labial fat pad interposition improves symptom resolution and reduces recurrence

Urethral diverticulectomy with Martius labial fat pad interposition improves symptom resolution and reduces recurrence

Transurethral laser lithotropsy in a female urethral diverticulum containing stones

Diverticula of the female urethra

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