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Recurrent pseudodiverticula of female urethra: five-year experience.
Urology. 2009 Jun; 73(6):1218-22.U

Abstract

OBJECTIVES

To report our experience of transvaginal diverticulectomy with pubovaginal sling placement in a series of 32 women with recurrent urethral pseudodiverticula.

METHODS

A total of 32 women underwent surgical repair from January 2000 to June 2007. Of the 32 women, 12 had undergone other concomitant previous urethral surgery, predominantly for stress urinary incontinence. Transvaginal excision of the diverticulum and concomitant pubovaginal sling placement were performed routinely. The women were evaluated postoperatively for symptom relief, anatomic result, and postoperative continence status at 1, 6, and 12 months and annually thereafter. Pelvic magnetic resonance imaging was repeated after 1 year.

RESULTS

The mean follow-up was 4.3 years. In all cases, the voiding urethrogram after catheter removal showed a good urethral shape with an absence of urinary leaks. At the postoperative urodynamic investigation, 27 patients had an unobstructed and 5 an equivocal Blaivas-Groutz nomogram. Three patients (20%) reported a persistent degree of stress urinary incontinence, including 2 with grade 1 stress urinary incontinence and 1 with mixed incontinence. Two patients presented with clinically evident diverticulum recurrence, and in 1 patient, an intraurethral diverticulum, was found at the 1-year magnetic resonance imaging examination.

CONCLUSIONS

A pubovaginal sling added routinely to all diverticulectomy procedures offers significant support to the urethral repair and/or prevention of urinary incontinence, including in recurrent cases, and does not increase the risk of erosion into the urethra or fistula formation.

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Authors+Show Affiliations

Migliari R
U.O.C. Urologia, Ospedale S. Giovanni Bosco, Torino, Italy. r.migliari@tin.it
Pistolesi D
No affiliation info available
D'Urso L
No affiliation info available
Muto G
No affiliation info available

MeSH

AdultDiverticulumFemaleHumansMiddle AgedRecurrenceSuburethral SlingsTime FactorsUrethral DiseasesUrinary Incontinence, StressYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19375782

Citation

Migliari, Roberto, et al. "Recurrent Pseudodiverticula of Female Urethra: Five-year Experience." Urology, vol. 73, no. 6, 2009, pp. 1218-22.
Migliari R, Pistolesi D, D'Urso L, et al. Recurrent pseudodiverticula of female urethra: five-year experience. Urology. 2009;73(6):1218-22.
Migliari, R., Pistolesi, D., D'Urso, L., & Muto, G. (2009). Recurrent pseudodiverticula of female urethra: five-year experience. Urology, 73(6), 1218-22. https://doi.org/10.1016/j.urology.2008.07.040
Migliari R, et al. Recurrent Pseudodiverticula of Female Urethra: Five-year Experience. Urology. 2009;73(6):1218-22. PubMed PMID: 19375782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrent pseudodiverticula of female urethra: five-year experience. AU - Migliari,Roberto, AU - Pistolesi,Donatella, AU - D'Urso,Leonardo, AU - Muto,Giovanni, Y1 - 2009/04/18/ PY - 2008/05/17/received PY - 2008/07/08/revised PY - 2008/07/15/accepted PY - 2009/4/21/entrez PY - 2009/4/21/pubmed PY - 2009/7/2/medline SP - 1218 EP - 22 JF - Urology JO - Urology VL - 73 IS - 6 N2 - OBJECTIVES: To report our experience of transvaginal diverticulectomy with pubovaginal sling placement in a series of 32 women with recurrent urethral pseudodiverticula. METHODS: A total of 32 women underwent surgical repair from January 2000 to June 2007. Of the 32 women, 12 had undergone other concomitant previous urethral surgery, predominantly for stress urinary incontinence. Transvaginal excision of the diverticulum and concomitant pubovaginal sling placement were performed routinely. The women were evaluated postoperatively for symptom relief, anatomic result, and postoperative continence status at 1, 6, and 12 months and annually thereafter. Pelvic magnetic resonance imaging was repeated after 1 year. RESULTS: The mean follow-up was 4.3 years. In all cases, the voiding urethrogram after catheter removal showed a good urethral shape with an absence of urinary leaks. At the postoperative urodynamic investigation, 27 patients had an unobstructed and 5 an equivocal Blaivas-Groutz nomogram. Three patients (20%) reported a persistent degree of stress urinary incontinence, including 2 with grade 1 stress urinary incontinence and 1 with mixed incontinence. Two patients presented with clinically evident diverticulum recurrence, and in 1 patient, an intraurethral diverticulum, was found at the 1-year magnetic resonance imaging examination. CONCLUSIONS: A pubovaginal sling added routinely to all diverticulectomy procedures offers significant support to the urethral repair and/or prevention of urinary incontinence, including in recurrent cases, and does not increase the risk of erosion into the urethra or fistula formation. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/19375782/Recurrent_pseudodiverticula_of_female_urethra:_five_year_experience_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(08)01369-1 DB - PRIME DP - Unbound Medicine ER -