Document Detail

Urethral diverticulectomy and pubovaginal sling for simultaneous treatment of urethral diverticulum and intrinsic sphincter deficiency.
MedLine Citation:
PMID:  9892000     Owner:  NLM     Status:  MEDLINE    
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.
G J Faerber
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Techniques in urology     Volume:  4     ISSN:  1079-3259     ISO Abbreviation:  Tech Urol     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-03-24     Completed Date:  1999-03-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9508161     Medline TA:  Tech Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  192-7     Citation Subset:  IM    
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0330, USA.
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MeSH Terms
Aged, 80 and over
Diverticulum / complications,  physiopathology,  surgery*
Follow-Up Studies
Middle Aged
Prosthesis Implantation
Retrospective Studies
Treatment Outcome
Urethral Diseases / complications,  physiopathology,  surgery*
Urinary Incontinence, Stress / etiology,  physiopathology,  surgery*
Urologic Surgical Procedures*
Vagina / surgery*

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