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Transurethral endoscopic extensive incision of complex urethral diverticula in symptomatic women: case series in a single center experience with long-term follow-up

  • Urology - Original Paper
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Abstract

Background

Urethral diverticula (UD) affect 1–6% of adult women. Complex UD are rare, but can be challenging to manage. To evaluate the efficacy and safety of transurethral endoscopic extensive incision of complex UD in symptomatic women.

Materials and methods

We retrospectively evaluated 22 female patients with complex UD who underwent transurethral endoscopic extensive incision management in our hospital. This technique was completed by one experienced surgeon over a 7-year period between August 2012 and July 2019. The surgical technique involved placing the patient in a lithotomy position, inserting the needle electrode endoscopically, and incising the tented roof of the UD from its orifice until the entire roof had been opened widely. Outcome data included complete symptom resolution rate, imaging data, de novo stress urinary incontinence (SUI), recurrence, short-term and long-term complications. Cure was defined as decreased UD volume on postoperative magnetic resonance imaging and no post-voiding urinary retention in the diverticular cavity, with symptom resolution.

Results

The initial symptom-resolution rate after 37.0 (27.0, 50.0) months’ follow-up was 81.80% (18/22) and the de novo SUI rate was 13.60% (3/22). No patients required additional operations after conservative therapy. There was no symptomatic or imaging recurrence, and no short-term complications.

Conclusion

Transurethral endoscopic extensive incision was an effective and safe treatment for symptomatic female complex UD. Its symptom-resolution rate and de novo SUI rate might be superior to the conventional transvaginal approach. Moreover, it was less invasive and easier to conduct, with fewer complications.

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Acknowledgements

We give special thanks to all the teachers at the Department of Urology of Sheng**g Hospital for their help and support.

Funding

This study was financially supported by the Sheng**g Hospital Science and Technology Program (MC05).

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Author notes

  1. Bin Wu and Song Bai contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Sheng**g Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People’s Republic of China

    Bin Wu, Song Bai, Zichuan Yao, **anqing Zhu, Yunzhong Jiang & Jia Li

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  1. Bin Wu
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  2. Song Bai
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  3. Zichuan Yao
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  4. **anqing Zhu
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Contributions

JL had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JL. Acquisition of data, analysis and interpretation of data: BW, SB, ZY and XZ. Drafting of the manuscript and critical revision of the manuscript for important intellectual content: BW and SB; Statistical analysis: YJ. Obtaining funding and other (figures): JL.

Corresponding author

Correspondence to Jia Li.

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Conflict of interest

The authors: Bin Wu, Song Bai, Zichuan Yao, **anqing Zhu, Yunzhong Jiang, Jia Li declare that they have no competing interests.

Ethical statement

Ethical approval (Ethics Committee No. 2020PS172K) was provided by the Institutional Research and Ethics Committee of the Sheng**g Hospital Affiliated China Medical University in Shengyang, China. Informed consent was obtained from all eligible patients. Research Registry UIN website: http://www.chictr.org.cn/index.aspx, registration UIN is ChiCTR2000030880.

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Informed consent from all eligible patients was obtained.

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Wu, B., Bai, S., Yao, Z. et al. Transurethral endoscopic extensive incision of complex urethral diverticula in symptomatic women: case series in a single center experience with long-term follow-up. Int Urol Nephrol 53, 1279–1287 (2021). https://doi.org/10.1007/s11255-021-02808-8

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