MP65-18 FEMALE URETHRAL DIVERTICULA: CORRELATION OF MRI FINDINGS WITH PRE-OPERATIVE SIGNS AND SYMPTOMS OR POST-OPERATIVE OUTCOMES

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II1 Apr 2016MP65-18 FEMALE URETHRAL DIVERTICULA: CORRELATION OF MRI FINDINGS WITH PRE-OPERATIVE SIGNS AND SYMPTOMS OR POST-OPERATIVE OUTCOMES Nima Baradaran, Leah Chiles, Drew Freilich, William Rawls, Lindsey Cox, Ross Rames, and Eric Rovner Nima BaradaranNima Baradaran More articles by this author , Leah ChilesLeah Chiles More articles by this author , Drew FreilichDrew Freilich More articles by this author , William RawlsWilliam Rawls More articles by this author , Lindsey CoxLindsey Cox More articles by this author , Ross RamesRoss Rames More articles by this author , and Eric RovnerEric Rovner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1229AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pelvic MRI (pMRI) provides excellent anatomic delineation of urethral diverticula (UD) and is routinely utilized for preoperative planning and patient counselling. Determining whether preoperative pMRI findings are correlated with severity of the condition or postoperative success is the objective of this study. METHODS After IRB approval, records of adult females who underwent transvaginal excision of UD (TVUD) at our institution between 2004 and 2014 were retrospectively reviewed. Clinical characteristics before and after TVUD including lower urinary tract symptoms, incontinence status, dyspareunia, postvoid dribbling, and urinary tract infections were reviewed and correlated with preoperative pMRI findings. MRI characteristics included UD configuration (simple, saddlebag, or circumferential), size, location (proximal, mid, or distal urethra), and number of UD. An autologous fascia pubovaginal sling was placed at the time of UD excision if stress urinary incontinence was present preoperatively. RESULTS 58 patients underwent TVUD of which 49 patients had available data on preoperative pMRI. Three patients had a previous TVUD at other institutions. UD was located in the proximal urethra in 36%, midurethra in 43%, and distal urethra in 6%. Four (8%) patients had panurethral involvement. Median (range) size of the UD on largest dimension was 2.5cm (0.5-6.7). UD configuration was simple in 37%, saddlebag in 37%, and circumferential in 24% of cases. Size, configuration, and location of UD on pMRI were not predictive of symptoms at presentation or symptom severity. However, distal and pan-urethral UD were correlated with presence of vaginal mass on physical examination (p=0.04). Larger UD size (>3 cm) was associated with higher intraoperative blood loss (450cc vs. 200cc, p<0.001) as was placement of a concomitant sling at the time of TVUD (275cc vs. 200cc, p=0.03). Complete resolution of UD on voiding cystourethrogram was achieved postoperatively in 65% of patients however only 3 (5%) patients required subsequent surgical intervention for persistent UD. There was no correlation with preoperative pMRI characteristics and resolution of UD on postoperative imaging. CONCLUSIONS Although pMRI provides valuable anatomical information for surgical planning, preoperative pMRI findings are not correlated with patients’ presenting symptoms, signs, or postoperative outcomes. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e871 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nima Baradaran More articles by this author Leah Chiles More articles by this author Drew Freilich More articles by this author William Rawls More articles by this author Lindsey Cox More articles by this author Ross Rames More articles by this author Eric Rovner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...