SpringerLink
Log in

Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

We aimed to report surgical outcomes in female urethral diverticula and to investigate the risk factors for diverticula recurrence.

Methods

A total of 66 patients underwent urethral diverticulectomies from January 2009 to October 2015 at out institution. Patient and diverticula characteristics were collected. Mean follow-up was 28.8 months (range 4–85 months). Recurrence was defined as requiring a repeat diverticulectomy.

Results

Mean age was 44.9 years. Mean duration of symptoms was 28.1 months. Seven cases had previous urethral surgeries. Mean diverticula size was 2.8 cm. Main clinical symptoms included dribbling (n = 41), vaginal mass (n = 41), dysuria (n = 33), frequency/urgency (n = 29), infection (n = 24), stress urinary incontinence (SUI) (n = 20) and dyspareunia (n = 8). 10 cases had proximal diverticula, 10 cases had multiple diverticula, and 35 cases had horseshoe/circumferential diverticula. Postoperatively, the recurrence rate was 19.7 %. Preoperative SUI disappeared in 14 cases, and de novo SUI was developed in six cases. One case developed urethral stricture, and no cases reported urinary fistula. Among 60 cases with pathological results, neoplastic change was seen in one case (1.7 %). Besides, atypical hyperplasia (n = 2) and metaplasia (n = 3) were observed. Univariate analysis suggested that age, duration, follow-up, diverticula size and diverticula shape were not associated with surgical outcomes. Patients with multiple diverticula (p = 0.032), proximal diverticula (p = 0.042) and those with previous urethral procedures (p = 0.004) were at risk of recurrent diverticula confirmed by multivariate logistic regression analysis.

Conclusions

The surgical outcomes of urethral diverticulectomies were acceptable. Multiple diverticula, proximal diverticula and previous urethral surgery were three independent risk factors for recurrent diverticula.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (France)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aspera AM, Rackley RR, Vasavada SP (2002) Contemporary evaluation and management of the female urethral diverticulum. Urol Clin North Am 29:617–624

    Article  PubMed  Google Scholar 

  2. Andersen MJ (1967) The incidence of diverticula in the female urethra. J Urol 98:96–98

    CAS  PubMed  Google Scholar 

  3. Romanzi LJ, Groutz A, Blaivas JG (2000) Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement. J Urol 164:428–433

    Article  CAS  PubMed  Google Scholar 

  4. Crescenze IM, Goldman HB (2015) Female urethral diverticulum: current diagnosis and management. Curr Urol Rep 16:71

    Article  PubMed  Google Scholar 

  5. Han DH, Jeong YS, Choo MS et al (2007) Outcomes of surgery of female urethral diverticula classified using magnetic resonance imaging. Eur Urol 51:1664–1670

    Article  PubMed  Google Scholar 

  6. Bodner-Adler B, Halpern K, Hanzal E (2015) Surgical management of urethral diverticula in women: a systematic review. Int Urogynecol J. doi:10.1007/s00192-015-2862-y

    PubMed  Google Scholar 

  7. Ockrim JL, Allen DJ, Shah PJ et al (2009) A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes. BJU Int 103:1550–1554

    Article  PubMed  Google Scholar 

  8. Reeves FA, Inman RD, Chapple CR (2014) Management of symptomatic urethral diverticula in women: a single-centre experience. Eur Urol 66:164–172

    Article  PubMed  Google Scholar 

  9. Ingber MS, Firoozi F, Vasavada SP et al (2011) Surgically corrected urethral diverticula: long-term voiding dysfunction and reoperation rates. Urology 77:65–69

    Article  PubMed  Google Scholar 

  10. Porpiglia F, Destefanis P, Fiori C et al (2002) Preoperative risk factors for surgery female urethral diverticula. Our experience. Urol Int 69:7–11

    Article  PubMed  Google Scholar 

  11. Greenwell TJ, Spilotros M (2015) Urethral diverticula in women. Nat Rev Urol 12:671–680

    Article  PubMed  Google Scholar 

  12. Huffman JW (1948) The detailed anatomy of the paraurethral ducts in the adult human female. Am J Obstet Gynecol 55:86–101

    Article  CAS  PubMed  Google Scholar 

  13. Athanasopoulos A, McGuire EJ (2008) Urethral diverticulum: a new complication associated with tension-free vaginal tape. Urol Int 81:480–482

    Article  CAS  PubMed  Google Scholar 

  14. Chang YL, Lin AT (2010) Female urethral diverticula—an update. Urol Sci 21:23–29

    Article  Google Scholar 

  15. Antosh DD, Gutman RE (2011) Diagnosis and management of female urethral diverticulum. Female Pelvic Med Reconstr Surg 17:264–271

    Article  PubMed  Google Scholar 

  16. Thomas AA, Rackley RR, Lee U et al (2008) Urethral diverticula in 90 female patients: a study with emphasis on neoplastic alterations. J Urol 180:2463–2467

    Article  PubMed  Google Scholar 

  17. Foster RT, Amundsen CL, Webster GD (2007) The utility of magnetic resonance imaging for diagnosis and surgical planning before transvaginal periurethral diverticulectomy in women. Int Urogynecol J Pelvic Floor Dysfunct 18:315–319

    Article  PubMed  Google Scholar 

  18. Chou CP, Levenson RB, Elsayes KM et al (2008) Imaging of female urethral diverticulum: an update. Radiographics 28:1917–1930

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Grant Nos. 81300579, 31370951, 81470927 and 81300579 from the National Natural Science Foundation of China, Grant No. JH2015017 from the Applied Key Project of Sichuan Province, Grant No. JH2014053 from the Foundation for Reserve Candidates of Science and Technology leader of Sichuan Province and Grant No. 2014SCU04B21 from the Foundation for Outstanding Young in Sichuan University, Grant No. 2014SZ0028 from the Support Project of the Ministry of Science and Technology of Sichuan Province and 1.3.5. Project for disciplines of excellence, West China Hospital, Sichuan University.

Authors’ contribution

Liang Zhou was involved in data collection, data analysis, manuscript writing and follow-up. De-Yi Luo was involved in data collection and manuscript writing. Shi-Jian Feng took part in data analysis. The pathological data and imaging data were collected by Qi Liu and **n Wei, respectively. Yi-Fei Lin and Tao ** were involved in follow-up. Hong Li participated in manuscript revision. Kun-Jie Wang took part in project development and manuscript revision. Hong Shen was involved in project development, manuscript revision and performing surgeries.

Author information

Author notes

    Authors and Affiliations

    1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guo xue xiang 37, Cheng Du, 610041, Sichuan, China

      Liang Zhou, De-Yi Luo, Shi-Jian Feng, **n Wei, Yi-Fei Lin, Tao **, Hong Li, Kun-Jie Wang & Hong Shen

    2. Department of Medical Imaging, West China Hospital, Sichuan University, Guo xue xiang 37, Cheng Du, 610041, Sichuan, China

      Qi Liu

    Authors
    1. Liang Zhou
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. De-Yi Luo
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Shi-Jian Feng
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. **n Wei
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Qi Liu
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Yi-Fei Lin
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Tao **
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Hong Li
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. Kun-Jie Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    10. Hong Shen
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding authors

    Correspondence to Kun-Jie Wang or Hong Shen.

    Ethics declarations

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Additional information

    Liang Zhou and De-Yi Luo have contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Zhou, L., Luo, DY., Feng, SJ. et al. Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients. World J Urol 35, 139–144 (2017). https://doi.org/10.1007/s00345-016-1815-5

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00345-016-1815-5

    Keywords

    Search

    Navigation