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Female urethral diverticulum: 26-year followup of a large series.

Journal article
Authors Lena Ljungqvist
Ralph Peeker
Magnus Fall
Published in J Urol
Volume 177
Issue 1
Pages 219-224
Publication year 2007
Published at Institute of Clinical Sciences
Pages 219-224
Language en
Links dx.doi.org/10.1016/j.juro.2006.08.0...
Keywords diverticulum; urethra; surgical flaps; pain; urinary incontinence
Subject categories Urology and andrology

Abstract

Purpose Female urethral diverticulum is an acquired condition associated with distressing and chronic symptoms. Surgery sometimes represents a technical challenge and various complications may follow treatment. We present the results of a retrospective analysis in a large personal series operated on during a 26-year period. Materials and Methods A total of 68 women underwent surgery. The medical records of all women were reviewed and a followup telephone interview was conducted by an investigator not involved in the care of the patients. There were 64 women available for the interview who were questioned using a standard questionnaire. Results In the majority of patients the postoperative course was uneventful and no complications were encountered. However, a relative stricture of the urethra developed in 1 woman and fistulas developed in 4. In 1 patient the fistula was small and distal, and was left without further surgery. Although diverticulum recurred in 11 patients and urinary incontinence of varying degrees was rather common, as was dyspareunia, 59 patients (92%) would still recommend surgery to a friend having symptoms of the severity they had experienced themselves. Conclusions Residual symptoms were surprisingly common in the long term. However, most of them were tolerable and it is noteworthy that almost all patients found the operation quite worthwhile when looking back to their preoperative situation. It was evident that repeated surgery frequently resulted in various sequela. The first operation is the golden opportunity for long-term success and a lesson to be learned is that operations for female urethral diverticulum would preferably be centralized to a limited number of surgeons.

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