1555 PUBOVAGINAL SLING IN THE TREATMENT OF CONCOMITANT FEMALE URETHRAL DIVERTICULA AND STRESS URINARY INCONTINENCE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology I1 Apr 20121555 PUBOVAGINAL SLING IN THE TREATMENT OF CONCOMITANT FEMALE URETHRAL DIVERTICULA AND STRESS URINARY INCONTINENCE Ekene Enemchukwu, W. Stuart Reynolds, Harriette Scarpero, Melissa Kaufman, and Roger Dmochowski Ekene EnemchukwuEkene Enemchukwu Nashville, TN More articles by this author , W. Stuart ReynoldsW. Stuart Reynolds Nashville, TN More articles by this author , Harriette ScarperoHarriette Scarpero Nashville, TN More articles by this author , Melissa KaufmanMelissa Kaufman Nashville, TN More articles by this author , and Roger DmochowskiRoger Dmochowski Nashville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1325AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Female urethral diverticulum is a rare condition with nonspecific symptoms. Consequently, diagnosis is often delayed. There is a paucity of data on the management and outcomes. Surgical management of female urethral diverticula and concomitant stress urinary incontinence (SUI) with pubovaginal sling (PVS) has been shown to be safe and effective in small series. We present our experience with concomitant repair. METHODS Retrospective chart review from 2006 to 2009 identified 22 women undergoing concomitant diverticulectomy and autologous fascia PVS. Demographics, symptoms, urodynamics (UDS), prior treatments, concomitant procedures, pads per day (PPD), outcomes and complications were evaluated. RESULTS Mean age was 50.2. Mean duration of symptoms was 71.2 months. Follow up was 307 days. Magnetic resonance imaging was utilized in 19 patients and 3 were evaluated with voiding cystourethrogram. Seven patients presented with recurrent diverticula status post >1 repairs. All women had demonstrable SUI on exam or UDS. Two patients experienced post-operative retention, one requiring short term intermittent catheterization. Pre and post-operative PPD were 2.6 and 0, respectively. 60% patients reported mixed urinary symptoms prior to repair. Of these, 8 had complete resolution while 5 had significant improvement. Overall, 16 (73%) patients reported cure, while 5 (22%) were improved. One patient experienced recurrence of her urethral diverticulum with SUI after 23 months. No de novo detrusor overactivity, perioperative complications, including hemorrhage, vaginal erosion, fistula or hernias were observed. CONCLUSIONS To our knowledge, this represents the largest series of concomitant repair of SUI and urethral diverticulum. In this series, autologous fascia PVS is a safe and effective in women undergoing primary as well as repeat diverticulectomy. In addition to treatment of SUI symptoms, placement of a PVS may provide tissue interposition to reduce erosion, fistula, and additional post-operative complications. Future directions include determining the prevalence of SUI in those with recurrent urethral diverticula, as this population may be at higher risk and require more preoperative evaluation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e630-e631 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ekene Enemchukwu Nashville, TN More articles by this author W. Stuart Reynolds Nashville, TN More articles by this author Harriette Scarpero Nashville, TN More articles by this author Melissa Kaufman Nashville, TN More articles by this author Roger Dmochowski Nashville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...