A prospective cohort trial evaluating sexual function after urethral diverticulectomy.
Diana Hoehn1, Stefan Mohr1, Łukasz Nowakowski2
1Urogynaecology, Department of Gynaecology, Women's Clinic, Inselspital, Bern, Switzerland.
Summary
Urethral diverticulum surgery significantly improves female sexual function across all domains, including pain and satisfaction. While some urinary function parameters slightly change, the overall impact on sexual health is positive and clinically meaningful.
Area of Science:
- Urology
- Female Sexual Health
- Surgical Outcomes
Background:
- Dyspareunia affects up to 60% of women with urethral diverticulum.
- Previous studies suggest pain relief post-diverticulectomy, but data on sexual function is limited.
Purpose of the Study:
- To quantify sexual function and evaluate lower urinary tract symptoms in sexually active women after urethral diverticulum resection.
- To assess the postoperative impact of diverticulectomy on female sexual health.
Main Methods:
- Prospective cohort study of 40 sexually active women with symptomatic urethral diverticulum.
- Standardized surgical resection with inverted U-shape colpotomy.
- Assessment using the Female Sexual Function Index (FSFI) and urodynamic evaluation at baseline and 12 months postoperatively.
Main Results:
- Sexual function improved significantly in all FSFI domains (total score, satisfaction, pain, arousal, lubrication, desire, orgasm) in 38 patients.
- Maximum urethral closure pressure decreased, and post-void residual urine increased, but these changes were not clinically significant.
- Malignancy was detected in two patients, necessitating exclusion from statistical analysis.
Conclusions:
- Urethral diverticulum resection leads to substantial improvements in female sexual function and satisfaction.
- While minor changes in urethral closure pressure and residual urine occur, lower urinary tract function remains clinically stable.
- Histological examination of excised tissue is crucial due to the potential for unexpected malignancy.
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