title: Outcomes of surgery of female urethral diverticula classified using magnetic resonance imaging.
abstract: OBJECTIVE
  We evaluated the surgical outcomes of transvaginal diverticulectomies classified using magnetic resonance imaging (MRI).
  
  
  METHODS
  We evaluated 30 women (mean age: 46.4 yr; range: 31-73 yr) who were followed up for at least 12 mo after urethral diverticulectomies (mean follow-up: 29 mo; range: 12-93 mo). Characteristics of urethral diverticula were confirmed before surgery by MRI. Diverticula were classified as simple, U-shaped, or circumferential according to MRI features. Transvaginal excisions of urethral diverticula were performed using vaginal flaps and three-layer closures. Cure was defined as the absence of a diverticulum and symptoms.
  
  
  RESULTS
  Seventeen cases (57%) had simple diverticula, three (10%) had U-shaped diverticula, and 10 (33%) had circumferential diverticula. After the first operation, 23 cases (77%) were cured. None of the simple diverticula recurred, but 33% of the U-shaped and 60% of the circumferential diverticula did recur. Of the seven recurrent cases, three did not require a second operation because their symptoms resolved. Of the four cases that underwent a second operation, three were cured and one was cured after two additional operations. The success rate for circumferential diverticula after initial diverticulectomies was less than that of simple or U-shaped diverticula (p<0.05). Location, size, and multiplicity of urethral diverticula did not affect the surgical outcome (p>0.05).
  
  
  CONCLUSIONS
  Transvaginal diverticulectomy is effective for treatment of female urethral diverticula. For circumferential urethral diverticula, however, surgical procedures should be adapted to achieve complete resections of the diverticulum.
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Deok Hyun
authors.initials: DH
authors.lastname: Han
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Jeong
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D004240:Diverticulum / Q000145:classification* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011379:Prognosis; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000145:classification* / Q000601:surgery*; D014621:Vagina