Preoperative Risk Factors for Surgery of Female Urethral Diverticula

Abstract

Introduction: This study describes the authors’ experience about the most important risk factors in surgical treatment of female urethral diverticula. The attention is focused on the correlation between risk factors and common severe complications after surgical treatment. Patients and Methods: Eighteen women underwent transvaginal diverticulectomy from 1990 to December 2000. Voiding cystourethrography and transvaginal ultrasonography were performed preoperatively. As far as location is concerned, 10 women developed a mid-urethral diverticula, the remaining had diverticula equally distributed over the distal and proximal urethra. Ten diverticula showed a posterior development, 6 a lateral one and 2 diverticula had horseshoe shape. In 6 cases, diverticulum was larger than 4 cm. Results: Follow-up ranged from 44 to 121 months. We recorded one urethrovaginal fistula, two genuine stress incontinence of new onset, associated in one case with recurrent diverticulum, and one recurrent diverticulum as major complications. Conclusions: The most important risk factors, evaluated with a statistical analysis, are represented by delayed diagnosis, size over 4 cm, and lateral or horseshoe shape of the diverticulum.