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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 06

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Ginecol Obstet Mex 2018; 86 (06)

Female urethral diverticulum: early diagnosis and surgical resection

Benardete-Harari DN, Alonso MM, Soto-Hurtado PP, Pascal-Pontón D, Meraz-Ávila D

Language: Spanish
References: 15
Page: 406-411
PDF size: 529.84 Kb.


ABSTRACT

Background: The urethral diverticulum is the formation of a sac between the urethra and the vagina. The treatment, dependent on the symptoms, can be conservative or surgical. The first consists of aspiration decompression, prophylactic antibiotics and urethral dilators. For surgical treatment there are several techniques, their choice will depend on the location of the diverticulum.
Objective: To report the clinical case of an infrequent condition that generates ignorance of the health professional to detect, treat and refer this type of patients. DESCRIBE the management of an uncommon case, reporting a favorable mediate and long-term postoperative evolution.
Clinical case: A 59-year-old patient attended the clinic due to a severe dysuria lasting several months, associated with an increase in the volume of the distal urethra, post-voiding drip, and severe pain in the vaginal region. Diagnosis of urethral diverticulum was made, and excision of the lesion was performed with favorable evolution.
Conclusions: The urethral diverticulum is a rare and suspected diagnosis, so there should be a high degree of suspicion in surgeons who address this area to avoid poor diagnosis, unnecessary reoperations and complications. The treatments are varied according to the type, anatomical location and symptomatology of the lesion.


REFERENCES

  1. Di Gregorio M, Lorge F, Dupont M, et al. Female Urethral Diverticulum: Diagnosis, Treatment and Outcome. Gynecol Obstet. 2016;6:4. doi: 10.4172/2161-0932.1000374.

  2. Mårtensson O, Duchek M. Translabial ultrasonography with pulsed colour-Doppler in the diagnosis of female urethral diverticula. Scand J Urol Nephrol 1994;28:101. https://www. tandfonline.com/doi/abs/10.3109/00365599409180480.

  3. Burrows LJ, Howden NL, Meyn L, Weber AM. Surgical procedures for urethral diverticula in women in the United States, 1979-1997. Int Urogynecol J Pelvic Floor Dysfunct 2005;16:158-161. https://www.tandfonline.com/doi/ abs/10.3109/00365599409180480.

  4. Athanasopoulos A, McGuire EJ. Urethral diverticulum: a new complication associated with tension-free vaginal tape. Urol Int 2008; 81:480-82. https://www.karger.com/ Article/Abstract/167852.

  5. Morton HC, Hilton P. Urethral injury associated with minimally invasive mid-urethral sling procedures for the treatment of stress urinary incontinence: a case series and systematic literature search. BJOG 2009; 116:1120. https:// doi.org/10.1111/j.1471-0528.2009.02199.x

  6. Cox L, Gilchrist AS, Rovner ES. Urethral Diverticulectomy. In: Goldman H. (eds) Complications of Female Incontinence and Pelvic Reconstructive Surgery. Current Clinical Urology. Humana Press, Cham. https://doi. org/10.1007/978-3-319-49855-3_20

  7. Foley CL, Greenwell TJ, Gardiner RA. Urethral diverticula in females. BJU Int 2011; 108 Suppl 2:20.

  8. Bastien L, Cortesse A. Tratamiento del divertículo uretral en la mujer. EMC-Urología 2014; 46(4):1-7.

  9. Thomas AA, Rackley RR, Lee U, et al. Urethral diverticula in 90 female patients: a study with emphasis on neoplastic alterations. J Urol 2008; 180:2463.

  10. Katmawi-Sabbagh S, Al-Qassim Z, Al-Sudani M, et al. Female urethral diverticulectomy: a new surgical approach. Trends in Urology and Men´s Health. 2018;14(6). https:// doi.org/10.1002/tre.130.

  11. Aspera AM, Rackley RR, Vasavada SP. Contemporary evaluation and management of the female urethral diverticulum. Urol Clin North Am 2002; 29:617-24.

  12. Singla P, Long SS, Long CM, et al. Imaging of the female urethral diverticulum. Clin Radiol 2013;68(7): e418- e425. DOI: https://doi.org/10.1016/j.crad.2013.02.006. Venyo AKG, Gopall A. Female urethral diverticula: a review of the literature. WebmedCentral UROLOGY 2012;3(5):WMC003428. https//doi: 10.9754/journal. wmc.2012.003428.

  13. Chou CP, Levenson RB, Elsayes KM, et al. Imaging of female urethral diverticulum: an update. Radiographics 2008;28:1917. https://doi.org/10.1148/rg.287075076.

  14. Romanzi LJ, Groutz A, Blaivas JG. Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement. J Urol 2000;164:428. https:// doi.org/10.1016/S0022-5347(05)67377-6.

  15. Fortunato P, Schettini M, Gallucci M. Diagnosis and therapy of the female urethral diverticula. Int Urogynecol J Pelvic Floor Dysfunct 2001;12:51. https://doi.org/10.1007/s001920170




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