Experience with the management of urethral diverticulum in 63 women

K. Ganabathi, G. E. Leach, P. E. Zimmern, R. Dmochowski

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

The presentation and management are reviewed of 63 women with urethral diverticulum seen at a single institution in 10 years. Of the women 36 (61.9%) had urinary incontinence as a presenting symptom and 20 (31.7%) had incontinence as the only presenting complaint. Diverticula were suspected in 57 cases (90.5%) based on the presence of a periurethral mass during pelvic examination. Investigations included voiding cystourethrogram, excretory urogram, urodynamic studies and recently transvaginal ultrasound. Voiding cystourethrography adequately demonstrated the diverticulum in 60 of the 63 women (95.2%). Urodynamic studies performed in 58 women revealed abnormal findings in 36 (62%), including genuine stress urinary incontinence in 28 (48.3%). The location/number/size/configuration, communication, continence classification was used to define the characteristics of the diverticula. Seven women either refused operation or had small asymptomatic diverticula not requiring treatment. Transvaginal diverticulectomy was performed using a 3-layer closure in 56 women. Concomitant bladder neck suspension was performed in 27 women with documented stress urinary incontinence and/or urethral hypermobility. With a mean followup of 70 months (range 6 to 136) 48 women (85.7%) were completely relieved of the presenting complaint. Complications of diverticulectomy included 2 small distal recurrent diverticula, 1 urethrovaginal fistula and 6 transient early urinary tract infections. None of the women had urethral stricture or recurrent urinary tract infection. Six women (22.2%) who underwent diverticulectomy and bladder neck suspension, and 3 (10.3%) treated with diverticulectomy alone had minimal urinary incontinence requiring less than 2 pads a day.

Original languageEnglish (US)
Pages (from-to)1445-1452
Number of pages8
JournalJournal of Urology
Volume152
Issue number5 I
StatePublished - 1994

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Diverticulum
Stress Urinary Incontinence
Urodynamics
Urinary Incontinence
Urinary Tract Infections
Suspensions
Urinary Bladder
Urethral Stricture
Gynecological Examination
Urography
Fistula
Communication

Keywords

  • diverticulum
  • urethra
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Ganabathi, K., Leach, G. E., Zimmern, P. E., & Dmochowski, R. (1994). Experience with the management of urethral diverticulum in 63 women. Journal of Urology, 152(5 I), 1445-1452.

Experience with the management of urethral diverticulum in 63 women. / Ganabathi, K.; Leach, G. E.; Zimmern, P. E.; Dmochowski, R.

In: Journal of Urology, Vol. 152, No. 5 I, 1994, p. 1445-1452.

Research output: Contribution to journalArticle

Ganabathi, K, Leach, GE, Zimmern, PE & Dmochowski, R 1994, 'Experience with the management of urethral diverticulum in 63 women', Journal of Urology, vol. 152, no. 5 I, pp. 1445-1452.
Ganabathi K, Leach GE, Zimmern PE, Dmochowski R. Experience with the management of urethral diverticulum in 63 women. Journal of Urology. 1994;152(5 I):1445-1452.
Ganabathi, K. ; Leach, G. E. ; Zimmern, P. E. ; Dmochowski, R. / Experience with the management of urethral diverticulum in 63 women. In: Journal of Urology. 1994 ; Vol. 152, No. 5 I. pp. 1445-1452.
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