title: Surgical Outcomes of Primary and Recurrent Female Urethral Diverticula.
abstract: OBJECTIVE
  To evaluate the surgical outcomes of female urethral diverticulectomy.
  
  
  METHODS
  We retrospectively analyzed the medical records of 68 patients with symptomatic urethral diverticula (UD) with at least 1 year of follow-up data following transvaginal urethral diverticulectomy conducted by a single surgeon. The presence of UD was confirmed by a preoperative magnetic resonance imaging (MRI). According to MRI findings, the UDs were classified as simple, U-shaped, or circumferential. Cure was defined as the absence of residual diverticulum on a postoperative MRI with a resolution of symptoms.
  
  
  RESULTS
  There were 27 cases (39.7%) of simple, 16 cases (23.5%) of U-shaped, and 25 cases (36.8%) of circumferential diverticula. The initial cure rate for UD was 77.9%. According to configuration, the cure rates for simple, U-shaped, and circumferential diverticula were 100%, 75.0%, and 64.0%, respectively (P = .043). Of the 15 patients with UD recurrence, 4 did not require reoperation because of symptom resolution. Of the 11 cases that underwent a second operation, 8 patients were cured: 7 via a Martius labial fat pad interposition (MLFI) procedure and 1 via simple excision without MLFI. The overall cure rate was 92.6%. The circumferential configuration was an independent factor for a lower cure rate (odds ratio, 7.97; 95% confidence interval, 1.14-55.69).
  
  
  CONCLUSIONS
  Transvaginal diverticulectomy is an effective treatment for female UD. The success rate of an initial surgery was significantly lower for UDs with circumferential configurations than for simple or U-shaped UDs. Regardless of the initial configuration, MLFI is a good treatment option for recurrent or persistent diverticula.
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang Jin
authors.initials: KJ
authors.lastname: Ko
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of the National Cancer Center, Goyang, Republic of Korea.
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Suh
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Heon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Urology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyo Serk
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Urology, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea.
authors.forename: Won Jin
authors.initials: WJ
authors.lastname: Cho
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Deok Hyun
authors.initials: DH
authors.lastname: Han
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: ksleedr@skku.edu.
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D004240:Diverticulum / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000601:surgery*