1846 THE EFFECT OF MRI CONFIGURATION ON NEW ONSET URODYNAMIC STRESS URINARY INCONTINENCE FOLLOWING URETHRAL DIVERTICULUM EXCISION

Abstract

INTRODUCTION AND OBJECTIVES: Excision of urethral diverticulum in females is associated with new onset urodynamic stress urinary incontinence (USUI) in up to 65%. We have assessed the incidence of new onset USUI in all patients having urethral diverticulum excision with Martius fat pad interposition under the care of a single surgeon between 1/5/2007 and 1/9/2012 and correlated this with the pre-operative MRI appearance of the urethral diverticulum. METHODS: 39 patients of median age 43, having urethral diverticulum with Martius fat pad interposition had prospective data tabulated on: demographics, pre-operative MRI appearance and pre and post-operative VCMG. RESULTS: Of these 39 patients, 12 (31%) had pre-operative USUI and are not included in this study. Other pre-operative urodynamic findings included IDO in 9 (23 %) and BOO in 17 (44%). The details regarding the incidence of new onset USUI in the remaining 27 patients are as tabulated. CONCLUSIONS: New onset USUI occurs in 11% of patients having excision of urethral diverticulum with Martius fat pad interposition. The incidence appears to increase with increasing complexity of urethral diverticulum on pre-operative MRI rising from 0% following simple urethral diverticulum excision to 22% following circumferential diverticulum excision.