Robot-assisted laparoscopic anterior urethral diverticulectomy.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Female Pelvic Medicine

Background:

• Recurrent vulvar abscesses and voiding dysfunction in a 31-year-old female were linked to a prior history of sacrococcygeal teratoma.
• Magnetic resonance imaging revealed a pelvic fluid collection, prompting investigation for underlying genitourinary abnormalities.

Observation:

• Cystoscopy identified a significant anterior urethral diverticulum.
• Surgical exploration revealed dense fibrotic tissue associated with the diverticulum, likely contributing to recurrent infections.

Findings:

• Robot-assisted laparoscopic surgery enabled precise resection of the anterior urethral diverticulum.
• Urethral reconstruction was performed using a multi-layered, tension-free technique with flap placement.

Implications:

• Robot-assisted laparoscopy provides a viable surgical option for rare female anterior urethral diverticula.
• Careful port placement and specialized techniques are crucial for managing distorted pelvic anatomy during this procedure.