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Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: A selective approach.
Neurourol Urodyn. 2018 01; 37(1):478-484.NU

Abstract

AIMS

To assess surgical outcomes of concomitant treatment of SUI at time of transvaginal urethral diverticulectomy (TVUD) based on a selective approach.

METHODS

Following Institutional Review Board (IRB) approval, we identified patients with a UD and SUI who underwent TVUD between July 2004 and January 2016. SUI was documented before and after surgery using subjective and objective parameters. Autologous pubovaginal slings (APVS) were used selectively based on surgeon and patient preference.

RESULTS

A total of 61 patients underwent surgical treatment of urethral diverticula; 39 patients with UD and concomitant SUI. Mean age was 53 years. Mean follow-up was 16.2 months. There were 24 patients (62%) with SUI that underwent concomitant APVS. There was resolution of SUI in 20 of 24 patients (83%) who underwent a simultaneous APVS compared to 8 of 15 patients (53%) who underwent TVUD without APVS. Surgery resulted in the improvement or resolution of the majority of preoperative symptoms including recurrent urinary tract infection (UTI) (82% vs 15%), dyspareunia (64% vs 8%), and urgency (56% vs 13%) (preoperative vs postoperative).

CONCLUSIONS

Female UD is often associated with SUI. Concomitant surgical treatment of UD and SUI often results in satisfactory control of bothersome SUI as well as other urinary symptoms such as UTI, dyspareunia and urgency. Treatment of SUI with APVS when undergoing TVUD is feasible with satisfactory outcomes.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Greiman A
Departmentof Urology, Medical University of South Carolina, Charleston, South Carolina.
Rittenberg L
Departmentof Urology, Medical University of South Carolina, Charleston, South Carolina.
Freilich D
Urology Specialists of Atlanta, Atlanta, Georgia.
Rames R
Departmentof Urology, Medical University of South Carolina, Charleston, South Carolina.
El-Zawahry A
Department of Urology, Southern Illinois University School of Medicine, Springfield, Illinois.
Koski M
Kaiser Permanente Urology, San Diego, California.
Rovner E
Departmentof Urology, Medical University of South Carolina, Charleston, South Carolina.

MeSH

AdultAgedDiverticulumDyspareuniaFemaleHumansLower Urinary Tract SymptomsMiddle AgedRetrospective StudiesSuburethral SlingsTreatment OutcomeUrethral DiseasesUrinary Incontinence, StressUrinary Tract InfectionsUrologic Surgical Procedures

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28660723

Citation

Greiman, Alyssa, et al. "Outcomes of Treatment of Stress Urinary Incontinence Associated With Female Urethral Diverticula: a Selective Approach." Neurourology and Urodynamics, vol. 37, no. 1, 2018, pp. 478-484.
Greiman A, Rittenberg L, Freilich D, et al. Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: A selective approach. Neurourol Urodyn. 2018;37(1):478-484.
Greiman, A., Rittenberg, L., Freilich, D., Rames, R., El-Zawahry, A., Koski, M., & Rovner, E. (2018). Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: A selective approach. Neurourology and Urodynamics, 37(1), 478-484. https://doi.org/10.1002/nau.23334
Greiman A, et al. Outcomes of Treatment of Stress Urinary Incontinence Associated With Female Urethral Diverticula: a Selective Approach. Neurourol Urodyn. 2018;37(1):478-484. PubMed PMID: 28660723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: A selective approach. AU - Greiman,Alyssa, AU - Rittenberg,Lauren, AU - Freilich,Drew, AU - Rames,Ross, AU - El-Zawahry,Ahmed, AU - Koski,Michelle, AU - Rovner,Eric, Y1 - 2017/06/29/ PY - 2017/03/16/received PY - 2017/05/17/accepted PY - 2017/7/1/pubmed PY - 2019/9/13/medline PY - 2017/6/30/entrez KW - diverticulum KW - female KW - stress KW - urethra KW - urinary incontinence SP - 478 EP - 484 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 37 IS - 1 N2 - AIMS: To assess surgical outcomes of concomitant treatment of SUI at time of transvaginal urethral diverticulectomy (TVUD) based on a selective approach. METHODS: Following Institutional Review Board (IRB) approval, we identified patients with a UD and SUI who underwent TVUD between July 2004 and January 2016. SUI was documented before and after surgery using subjective and objective parameters. Autologous pubovaginal slings (APVS) were used selectively based on surgeon and patient preference. RESULTS: A total of 61 patients underwent surgical treatment of urethral diverticula; 39 patients with UD and concomitant SUI. Mean age was 53 years. Mean follow-up was 16.2 months. There were 24 patients (62%) with SUI that underwent concomitant APVS. There was resolution of SUI in 20 of 24 patients (83%) who underwent a simultaneous APVS compared to 8 of 15 patients (53%) who underwent TVUD without APVS. Surgery resulted in the improvement or resolution of the majority of preoperative symptoms including recurrent urinary tract infection (UTI) (82% vs 15%), dyspareunia (64% vs 8%), and urgency (56% vs 13%) (preoperative vs postoperative). CONCLUSIONS: Female UD is often associated with SUI. Concomitant surgical treatment of UD and SUI often results in satisfactory control of bothersome SUI as well as other urinary symptoms such as UTI, dyspareunia and urgency. Treatment of SUI with APVS when undergoing TVUD is feasible with satisfactory outcomes. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/28660723/Outcomes_of_treatment_of_stress_urinary_incontinence_associated_with_female_urethral_diverticula:_A_selective_approach_ DB - PRIME DP - Unbound Medicine ER -