| Urethral diverticulectomy and pubovaginal sling for simultaneous treatment of urethral diverticulum and intrinsic sphincter deficiency. | |
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MedLine Citation:
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PMID: 9892000 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The purpose of this article is to determine the efficacy and safety of simultaneous urethral diverticulectomy and placement of a pubovaginal sling in patients with concomitant urethral diverticula and intrinsic sphincter deficiency (ISD). Sixteen women (mean age of 53 years) underwent simultaneous urethral diverticulectomy and pubovaginal sling. ISD was determined by fluorourodynamic evaluation and Valsalva leak point pressures. Treatment outcome was determined by resolution of the diverticula and change in individual incontinence grades before and after surgical repair. All 16 who underwent urethral diverticulectomy had symptomatic resolution at a mean follow-up of 25 months. Fourteen of 16 patients (88%) had no physical or radiologic evidence of residual or recurrent diverticula, while 2 of 16 (12%) had small, stable residual diverticula. All 16 patients reported significant improvement in incontinence status after placement of the pubovaginal sling, with 14 of 16 (88%) cured and 2 of 16 (12%) significantly improved. Five of 16 (31%) had mixed incontinence preoperatively: 2 of 5 had resolution of detrusor instability (DI) after surgery, 3 of 5 had persistent DI. De novo DI developed in two patients. No patient had erosion of the sling despite its close proximity to the urethral mucosal suture line. The average time to complete bladder emptying was approximately 5 weeks, and no patient developed permanent urinary retention. Simultaneous pubovaginal sling and urethral diverticulectomy can be performed safely without increased risk to the urethral reconstruction, yet with excellent continence rates. |
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Authors:
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G J Faerber |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Techniques in urology Volume: 4 ISSN: 1079-3259 ISO Abbreviation: Tech Urol Publication Date: 1998 Dec |
Date Detail:
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Created Date: 1999-03-24 Completed Date: 1999-03-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9508161 Medline TA: Tech Urol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 192-7 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0330, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Diverticulum / complications, physiopathology, surgery* Female Follow-Up Studies Humans Middle Aged Prosthesis Implantation Recurrence Retrospective Studies Treatment Outcome Urethral Diseases / complications, physiopathology, surgery* Urinary Incontinence, Stress / etiology, physiopathology, surgery* Urodynamics Urologic Surgical Procedures* Vagina / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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