An Eight-Year Experience of Transvaginal Urethral Diverticulectomy: A Single-Center Study
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Purpose: This study aimed to analyze and report the surgical outcomes in female patients with urethral diverticulum (UD) over an eight-year period at a single center. Materials and Methods: Data of 49 UD females who underwent transvaginal urethral diverticulectomy between October 2011 and December 2019 were collected. The characterization of UD was reviewed using pelvic imaging studies. The pre- and post-operative symptoms, post-operative complications, and pathological findings were analyzed by reviewing the medical records. Results: The most frequent pre-operative symptom was dysuria (n=18), followed by incontinence (n=14), and these symptoms persisted until 3 months post-operatively in one and six patients, respectively. Pre-operative incontinence was cured in eight patients; however, de novo stress urinary incontinence occurred in five patients within a month after surgery. Submucosal macroplastique injection was administered to these patients; of whom, one was cured and three showed an improvement. Recurrent UD was found in seven patients at a mean of 14.14±17.21 months post-operatively, and a repeat diverticulectomy was performed in six of them; of these, one recurred again and was cured after the third diverticulectomy. Urethral strictures were observed in two patients within a month after the operation but improved after urethral dilatation. Bleeding and surgical site infections were observed in one and two patients, respectively, but were successfully managed conservatively. According to the pathological report, only one was diagnosed with urethral adenocarcinoma. Conclusions: Transvaginal urethral diverticulectomy can effectively manage UD, and its post-operative complications can be successfully managed by a proper treatment.
Abstract
Purpose: This study aimed to analyze and report the surgical outcomes in female patients with urethral diverticulum (UD) over an eight-year period at a single center. Materials and Methods: Data of 49 UD females who underwent transvaginal urethral diverticulectomy between October 2011 and December 2019 were collected. The characterization of UD was reviewed using pelvic imaging studies. The pre- and post-operative symptoms, post-operative complications, and pathological findings were analyzed by reviewing the medical records. Results: The most frequent pre-operative symptom was dysuria (n=18), followed by incontinence (n=14), and these symptoms persisted until 3 months post-operatively in one and six patients, respectively. Pre-operative incontinence was cured in eight patients; however, de novo stress urinary incontinence occurred in five patients within a month after surgery. Submucosal macroplastique injection was administered to these patients; of whom, one was cured and three showed an improvement. Recurrent UD was found in seven patients at a mean of 14.14±17.21 months post-operatively, and a repeat diverticulectomy was performed in six of them; of these, one recurred again and was cured after the third diverticulectomy. Urethral strictures were observed in two patients within a month after the operation but improved after urethral dilatation. Bleeding and surgical site infections were observed in one and two patients, respectively, but were successfully managed conservatively. According to the pathological report, only one was diagnosed with urethral adenocarcinoma. Conclusions: Transvaginal urethral diverticulectomy can effectively manage UD, and its post-operative complications can be successfully managed by a proper treatment.
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