Mp81-13 outcomes of treatment of stress urinary incontinence associated with female urethral diverticula

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology1 Apr 2015MP81-13 OUTCOMES OF TREATMENT OF STRESS URINARY INCONTINENCE ASSOCIATED WITH FEMALE URETHRAL DIVERTICULA Drew Freilich, Ross Rames, Ahmed El-Zawahry, Eric Rovner, and Michelle Koski Drew FreilichDrew Freilich More articles by this author , Ross RamesRoss Rames More articles by this author , Ahmed El-ZawahryAhmed El-Zawahry More articles by this author , Eric RovnerEric Rovner More articles by this author , and Michelle KoskiMichelle Koski More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2891AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Female urethral diverticula (UD) may present with a variety of different symptoms including stress urinary incontinence (SUI). Surgical repair of SUI may be done concomitantly with urethral diverticulectomy. However, some surgeons may be reluctant to repair SUI at the time of urethral diverticulectomy due to the additional surgical time and potential morbidity of anti-incontinence surgery. We assessed surgical outcomes of the concomitant treatment of SUI at the time of transvaginal urethral diverticulectomy (TVUD). METHODS Following IRB approval, we identified patients with a UD and SUI who underwent TVUD between 2004 and 2014. SUI was documented before and after surgery using subjective and objective parameters. Martius flap and/or autologous pubovaginal fascial slings (APVS) were used selectively based on surgeon and patient preference. Postoperatively, all patients were imaged prior to catheter removal with voiding-cystourethrogram. RESULTS There were 35 pts (65%) with UD and concomitant SUI. Mean age was 52 years (range 34-77). There were 18 Caucasians, 17 African American. Mean follow-up was 15.4 months (Range 0-72). 22/35 patients with SUI underwent APVS concomitant to TVUD. Of these 22 patients, 4 had prior SUI surgery. 77% of patients who underwent a simultaneous APVS at the time of TVUD had resolution of SUI. 7 of 11 patients who underwent TVUD without APVS had resolution of SUI postoperatively (2 patients were lost to follow up). Five developed de-novo SUI following TVUD. Surgery resulted in the improvement or resolution of the majority of preoperative symptoms including recurrent urinary tract infection (UTI) (77% vs. 11%), dyspareunia (63% vs. 6%), and urgency (49% vs. 14.3%) (preoperative vs. postoperative). Complications included two patients with prolonged urinary retention following APVS requiring sling lysis. There was one patient with a recurrent UD 18 months postoperatively. CONCLUSIONS SUI is often associated with female UD. Surgical reconstruction of UD often results in satisfactory control of urinary symptoms including SUI when both are treated concomitantly. Treatment of SUI with APVS when undergoing TVUD is feasible with satisfactory outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1033-e1034 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Drew Freilich More articles by this author Ross Rames More articles by this author Ahmed El-Zawahry More articles by this author Eric Rovner More articles by this author Michelle Koski More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...