ABSTRACT
Objective To discuss the feasibility and the curative effect of transurethral diverticulum section in the treatment of female urethral diverticulum.Method We retrospectively analyzed the transurethral diverticulum section surgeries of 11 adult female patients diagnosed as urethral diverticulum in our hospital from August 2012 to October 2016.The patients aged from 33 years old to 74 years old with an average age of 43.Their medical histories varied from 1 month to more than 40 years with an average histories of 80 months.Major symptoms included odynuria,frequent micturition,dyspareunia,perineum bearing-down feeling,repetitive urinary tract infection,dysuria,urinary stuttering,penis masses,etc.One patient underwent TVT-O.Two patients had urinary catheterization before the disease.During physical examination,cystic masses of different sizes could be touched on anterior vaginal walls with pain and secretion.Cystic lesions can be found by imaging examination.Transurethral diverticulum section was performed under general anesthesia.Using needle electrode by resectoscope,we made an annular incision in the direction of the vertical axis of the urethra,from the beginning of diverticulum ostium.The diverticulum completely communicated with the urethra.In 11 patients of transurethral endoscopic,the urethral sphincter and the diverticulum wall appeared morphological integrity and no damage.There was no liquid drained to de vagina.There was no urethral sphincter injury and no urethral vaginal leakage.We observed the operation time,bleeding volume,diverticulum position,the number of diverticulum,urethral sphincter intraoperative.We also observed the postoperative symptoms,short-term and long-term complications.Result All surgeries went on well,in which urethral diverticula were fully opened.The operation time was 30-45 minutes,average 35 minutes.The amount of bleeding within 5 ml.4 cases with multiple diverticulum,with 2 cases of diverticulum ostia were 2,2 cases of diverticulum ostia were 3.The other 7 cases with single diverticulum,diverticulum ostium was 1.The catheters were removed 2 weeks after the surgery,after that all patients can urinate normally.The follow-up time was 5-55 months (mean,24 months).All pre-surgical symptoms disappeared and no complication occurred,such as urethral stricture,urinary incontinence,urethro-vaginal fistula,etc.Conclusion Transurethral diverticulum section is a reliable treatment for female urethral diverticulum with positive curative effect and no obvious complication.