Surgically corrected urethral diverticula: Long-term voiding dysfunction and reoperation rates

Michael S. Ingber, Farzeen Firoozi, Sandip P. Vasavada, Christina B. Ching, Howard B. Goldman, Courtenay K. Moore, Raymond R. Rackley

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objectives: To present the largest reported cohort of women with urethral diverticula and to evaluate the surgical outcomes and long-term voiding symptoms after urethral diverticulectomy. Studies evaluating the outcomes after urethral diverticulectomy have been limited by small patient numbers and short-term follow-up. Methods: Women who had undergone diverticulectomy at our institution from 1996 to 2008 were mailed surveys. Urinary bother was assessed using the Urogenital Distress Inventory 6-item questionnaire, and patients were asked to report subsequent urethral or vaginal surgery and the number of urinary tract infections within the previous year. To determine the rate of surgical recurrence, the charts of women not responding to the survey were reviewed. Results: A total of 122 women were identified as having undergone urethral diverticulectomy during the study period. Of these, 13 (10.7%) had an eventual recurrence that required repeat surgical excision. Patients with a proximal diverticulum, multiple diverticula, or previous pelvic or vaginal surgery (excluding previous diverticulectomy) were more likely to develop recurrence (P = .01, P = .03, and P < .001, respectively). For the 61 women (50%) responding to our survey, the mean follow-up was 50.4 months. Of these 61 women, 24 (39.3%) had had a urinary tract infection within the previous year, with 14 (23%) women having had <3 within the previous year. Also, 16 (26.2%) had persistent pain or discomfort with urination. The mean ± SD total Urogenital Distress Inventory-6 score was 31.1 ± 25.5 for the survey responders. Conclusions: To our knowledge, our study represents the largest study with the longest follow-up after urethral diverticulectomy. Patients with proximal or multiple diverticula and those with previous pelvic surgery should be counseled appropriately regarding the risks of recurrence and persistent voiding dysfunction.

Original languageEnglish (US)
Pages (from-to)65-69
Number of pages5
JournalUrology
Volume77
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

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Diverticulum
Reoperation
Recurrence
Urinary Tract Infections
Equipment and Supplies
Urination
Outcome Assessment (Health Care)
Surveys and Questionnaires
Pain

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Ingber, M. S., Firoozi, F., Vasavada, S. P., Ching, C. B., Goldman, H. B., Moore, C. K., & Rackley, R. R. (2011). Surgically corrected urethral diverticula: Long-term voiding dysfunction and reoperation rates. Urology, 77(1), 65-69. https://doi.org/10.1016/j.urology.2010.06.004
Ingber, Michael S. ; Firoozi, Farzeen ; Vasavada, Sandip P. ; Ching, Christina B. ; Goldman, Howard B. ; Moore, Courtenay K. ; Rackley, Raymond R. / Surgically corrected urethral diverticula : Long-term voiding dysfunction and reoperation rates. In: Urology. 2011 ; Vol. 77, No. 1. pp. 65-69.
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abstract = "Objectives: To present the largest reported cohort of women with urethral diverticula and to evaluate the surgical outcomes and long-term voiding symptoms after urethral diverticulectomy. Studies evaluating the outcomes after urethral diverticulectomy have been limited by small patient numbers and short-term follow-up. Methods: Women who had undergone diverticulectomy at our institution from 1996 to 2008 were mailed surveys. Urinary bother was assessed using the Urogenital Distress Inventory 6-item questionnaire, and patients were asked to report subsequent urethral or vaginal surgery and the number of urinary tract infections within the previous year. To determine the rate of surgical recurrence, the charts of women not responding to the survey were reviewed. Results: A total of 122 women were identified as having undergone urethral diverticulectomy during the study period. Of these, 13 (10.7{\%}) had an eventual recurrence that required repeat surgical excision. Patients with a proximal diverticulum, multiple diverticula, or previous pelvic or vaginal surgery (excluding previous diverticulectomy) were more likely to develop recurrence (P = .01, P = .03, and P < .001, respectively). For the 61 women (50{\%}) responding to our survey, the mean follow-up was 50.4 months. Of these 61 women, 24 (39.3{\%}) had had a urinary tract infection within the previous year, with 14 (23{\%}) women having had <3 within the previous year. Also, 16 (26.2{\%}) had persistent pain or discomfort with urination. The mean ± SD total Urogenital Distress Inventory-6 score was 31.1 ± 25.5 for the survey responders. Conclusions: To our knowledge, our study represents the largest study with the longest follow-up after urethral diverticulectomy. Patients with proximal or multiple diverticula and those with previous pelvic surgery should be counseled appropriately regarding the risks of recurrence and persistent voiding dysfunction.",
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Ingber, MS, Firoozi, F, Vasavada, SP, Ching, CB, Goldman, HB, Moore, CK & Rackley, RR 2011, 'Surgically corrected urethral diverticula: Long-term voiding dysfunction and reoperation rates', Urology, vol. 77, no. 1, pp. 65-69. https://doi.org/10.1016/j.urology.2010.06.004

Surgically corrected urethral diverticula : Long-term voiding dysfunction and reoperation rates. / Ingber, Michael S.; Firoozi, Farzeen; Vasavada, Sandip P.; Ching, Christina B.; Goldman, Howard B.; Moore, Courtenay K.; Rackley, Raymond R.

In: Urology, Vol. 77, No. 1, 01.01.2011, p. 65-69.

Research output: Contribution to journalArticle

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T1 - Surgically corrected urethral diverticula

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AU - Ingber, Michael S.

AU - Firoozi, Farzeen

AU - Vasavada, Sandip P.

AU - Ching, Christina B.

AU - Goldman, Howard B.

AU - Moore, Courtenay K.

AU - Rackley, Raymond R.

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N2 - Objectives: To present the largest reported cohort of women with urethral diverticula and to evaluate the surgical outcomes and long-term voiding symptoms after urethral diverticulectomy. Studies evaluating the outcomes after urethral diverticulectomy have been limited by small patient numbers and short-term follow-up. Methods: Women who had undergone diverticulectomy at our institution from 1996 to 2008 were mailed surveys. Urinary bother was assessed using the Urogenital Distress Inventory 6-item questionnaire, and patients were asked to report subsequent urethral or vaginal surgery and the number of urinary tract infections within the previous year. To determine the rate of surgical recurrence, the charts of women not responding to the survey were reviewed. Results: A total of 122 women were identified as having undergone urethral diverticulectomy during the study period. Of these, 13 (10.7%) had an eventual recurrence that required repeat surgical excision. Patients with a proximal diverticulum, multiple diverticula, or previous pelvic or vaginal surgery (excluding previous diverticulectomy) were more likely to develop recurrence (P = .01, P = .03, and P < .001, respectively). For the 61 women (50%) responding to our survey, the mean follow-up was 50.4 months. Of these 61 women, 24 (39.3%) had had a urinary tract infection within the previous year, with 14 (23%) women having had <3 within the previous year. Also, 16 (26.2%) had persistent pain or discomfort with urination. The mean ± SD total Urogenital Distress Inventory-6 score was 31.1 ± 25.5 for the survey responders. Conclusions: To our knowledge, our study represents the largest study with the longest follow-up after urethral diverticulectomy. Patients with proximal or multiple diverticula and those with previous pelvic surgery should be counseled appropriately regarding the risks of recurrence and persistent voiding dysfunction.

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