Pubovaginal sling for treatment of female stress urinary incontinence complicated by urethral diverticulum.
To evaluate the practicality of combining urethral diverticulectomy with a procedure for stress urinary incontinence, the records of 14 patients who underwent urethrodiverticulectomy during a 3-year period were reviewed. Noteworthy was that 10 patients (71%) had urinary incontinence as the chief complaint, while 8 (57%) had symptoms of stress urinary incontinence and underwent fluoroscopic urodynamic testing and the others had post-void dribbling. Of the latter 8 patients 7 (50%) demonstrated type II or type III stress urinary incontinence and 1 had a normal study. The 7 women then underwent transvaginal diverticulectomy with a concomitant pubovaginal sling. Of the diverticula 4 (57%) were true diverticula and 3 (43%) appeared to be pseudodiverticula or traction diverticula related to a previous urethral suspension. At 3 to 21 months (mean 17) all patients were cured of stress urinary incontinence. One patient exhibited detrusor instability postoperatively, which was ultimately treated with an Ingelman-Sundberg procedure. Postoperatively, 1 diverticulum recurred, for a recurrence rate of 14%. We conclude that the presence of a urethral diverticulum does not compromise successful repair of associated stress urinary incontinence when the pubovaginal sling procedure is used.
Swierzewski
S J
SJ
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
McGuire
E J
EJ
D000328:Adult; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D014522:Urethral Diseases / Q000150:complications / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery