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Simple vs complex urethral diverticulum: presentation and outcomes.

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Summary
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Circumferential urethral diverticula (cUD) present with more stress urinary incontinence but have similar surgical outcomes to simple UD (sUD). Repairing complex UD via urethral transection and anastomosis is a feasible approach.

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Area of Science:

  • Urology
  • Female Pelvic Medicine

Background:

  • Urethral diverticula (UD) are outpouchings of the urethra.
  • Complex UD (cUD) may have different presentations and outcomes compared to simple UD (sUD).

Purpose of the Study:

  • To compare the clinical presentation and prognosis of circumferential urethral diverticula (cUD) versus simple urethral diverticula (sUD).

Main Methods:

  • Retrospective review of 43 patients undergoing transvaginal urethral diverticulectomy.
  • 11 patients had cUD, repaired with urethral division, end-to-end anastomosis, and reconstructive techniques.
  • Surgical outcomes and presenting symptoms were analyzed.

Main Results:

  • Patients with cUD were more likely to present with stress urinary incontinence (90.9% vs 56.3%, P=.04).
  • No significant differences in other preoperative symptoms.
  • Postoperative urinary tract infection rates were higher in the cUD group (27% vs 3%, P=.2), but overall outcomes were similar.

Conclusions:

  • Urethral transection and end-to-end anastomosis is a feasible surgical approach for complex UD.
  • This technique yields clinical outcomes comparable to those for simple UD repair.