MP56-04 THE PRESENTATION, MANAGEMENT AND OUTCOME OF FEMALE URETHRAL DIVERTICULUM SURGERY – DIFFERENT BUT EQUALLY EFFECTIVE EITHER SIDE OF THE POND

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-04 THE PRESENTATION, MANAGEMENT AND OUTCOME OF FEMALE URETHRAL DIVERTICULUM SURGERY – DIFFERENT BUT EQUALLY EFFECTIVE EITHER SIDE OF THE POND Rachel Barratt, Catherine Culp, Helena Gresty, Jeremy Ockrim, Eric Rovner, and Tamsin Greenwell Rachel BarrattRachel Barratt More articles by this author , Catherine CulpCatherine Culp More articles by this author , Helena GrestyHelena Gresty More articles by this author , Jeremy OckrimJeremy Ockrim More articles by this author , Eric RovnerEric Rovner More articles by this author , and Tamsin GreenwellTamsin Greenwell More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess symptomatic and functional outcomes of urethral diverticulum excision in women and to compare management and outcomes at 2 high volume centres – 1 in the UK and 1 in the USA. METHODS: Retrospective review of the notes and imaging of all female patients having excision of a symptomatic urethral diverticulum between 2004 and 2018 for symptomatic urethral diverticulum. Data on patient demographics, urethral diverticulum characteristics and outcomes in particular symptomatic resolution, diverticulum recurrence and persistent/new onset urinary incontinece were noted.Statistical analysis was by Students T -Test and Chi-Squared. Significance was taken as P< 0.05. RESULTS: 191 women median age 45 years (range 19-78) had excision of their urethral diverticulum +/- Martius Fat Pad Interposition (N= 131) during the study period. 21(11%) patients had a simultaneous pubovaginal sling (PVS) or mid-urethral tape (MUT). 169 (88%) had preoperative pelvic MRI, 134 (79.2%) had pre-operative video-urodynamics and 124 (65%) had a complex urethral diverticulum.2 (1%) women had symptomatic and 3 (1.5%) had asymptomatic (on MRI only) urethral diverticulum recurrence at a mean follow-up of 24.2 months (range 0-156). Urinary incontinence was present in 164 (85.8%) pre-operatively and 64(33.5%) post-operatively; 32 (16.8%) of whom rated their incontinence as mild. Other symptomatic outcomes are detailed in Table 1: *P < 0.05 CONCLUSIONS: The commonest symptoms of urethral diverticulum are lump in the vagina, urethral or vaginal pain and dysuria. Following excision, the majority of symptoms resolve with urethral discharge most likely and frequency/urgency least likely to resolve. There are significant differences in outcomes for post-micturition dribble, urethral or vaginal pain, poor flow, recurrent UTIs and frequency/urgency between the 2 centres which most likely represent patient and diverticulum factors rather than treatment factors. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e970-e970 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rachel Barratt More articles by this author Catherine Culp More articles by this author Helena Gresty More articles by this author Jeremy Ockrim More articles by this author Eric Rovner More articles by this author Tamsin Greenwell More articles by this author Expand All Advertisement Loading ...