RESUMEN
PURPOSE: We evaluated the effects of a pubovaginal sling (PVS), with a Martius labial fat pad interposition (MLFI), on patients with a female urethral diverticulum. MATERIALS AND METHODS: 23 consecutive cases with a female urethral diverticulum were retrospectively reviewed. The pre-operative evaluations included the history, physical examination, voiding cystourethrogram, cystoscopy, transperineal ultrasound and urodynamic studies to investigate the urethral function and the concomitant stress urinary incontinence. The treatment consisted of a transvaginal diverticulectomy alone, or with a PVS only, or combined with a MLFI. RESULTS: A transvaginal diverticulectomy only was performed, using a 3-layer closure, in nine patients (39.1%) and a concomitant PVS with a diverticulectomy in eight (34.8%) with stress urinary incontinence. A MLFI, combined with the above procedure, was performed in six patients (26.1%) with large defects of the urethra following the resection of diverticulum. No women having undergone a diverticulectomy with, or without, a PVS and MLFI had an urethrovaginal fistula, recurrent diverticulum or postoperative incontinence. CONCLUSIONS: In complicated cases, a simultaneous transvaginal diverticulectomy, pubovaginal sling and Martius labial fat pad interposition can be performed safely and effectively.