Experience with a laterally based vaginal flap approach for urethral diverticulum

We found 15 cases of urethral diverticula in female patients who were evaluated for recurrent urinary tract infection. A voiding cystourethrogram was the most useful investigative technique. All cases were managed by a vaginal approach, using a laterally based flap incision. There were no complications with this easily learned technique, which makes full exposure of the diverticulum easy and covers the urethral defect with intact vaginal wall. Using this technique we have had no delayed healing, fistula formation or incontinence. A history of gonorrhea may have an etiologic role in acquired diverticula.