title: Female urethral diverticulum: 26-year followup of a large series.
abstract: OBJECTIVE
  Female urethral diverticulum is an acquired condition associated with distressing and chronic symptoms. Surgery sometimes represents a technical challenge and various complications may follow treatment. We present the results of a retrospective analysis in a large personal series operated on during a 26-year period.
  
  
  METHODS
  A total of 68 women underwent surgery. The medical records of all women were reviewed and a followup telephone interview was conducted by an investigator not involved in the care of the patients. There were 64 women available for the interview who were questioned using a standard questionnaire.
  
  
  RESULTS
  In the majority of patients the postoperative course was uneventful and no complications were encountered. However, a relative stricture of the urethra developed in 1 woman and fistulas developed in 4. In 1 patient the fistula was small and distal, and was left without further surgery. Although diverticulum recurred in 11 patients and urinary incontinence of varying degrees was rather common, as was dyspareunia, 59 patients (92%) would still recommend surgery to a friend having symptoms of the severity they had experienced themselves.
  
  
  CONCLUSIONS
  Residual symptoms were surprisingly common in the long term. However, most of them were tolerable and it is noteworthy that almost all patients found the operation quite worthwhile when looking back to their preoperative situation. It was evident that repeated surgery frequently resulted in various sequela. The first operation is the golden opportunity for long-term success and a lesson to be learned is that operations for female urethral diverticulum would preferably be centralized to a limited number of surgeons.
authors.affiliation: Department of Urology, Sahlgrenska University Hospital, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Ljungqvist
authors.forename: Ralph
authors.initials: R
authors.lastname: Peeker
authors.forename: Magnus
authors.initials: M
authors.lastname: Fall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014522:Urethral Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects