Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients
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We aimed to report surgical outcomes in female urethral diverticula and to investigate the risk factors for diverticula recurrence.
A total of 66 patients underwent urethral diverticulectomies from January 2009 to October 2015 at out institution. Patient and diverticula characteristics were collected. Mean follow-up was 28.8 months (range 4–85 months). Recurrence was defined as requiring a repeat diverticulectomy.
Mean age was 44.9 years. Mean duration of symptoms was 28.1 months. Seven cases had previous urethral surgeries. Mean diverticula size was 2.8 cm. Main clinical symptoms included dribbling (n = 41), vaginal mass (n = 41), dysuria (n = 33), frequency/urgency (n = 29), infection (n = 24), stress urinary incontinence (SUI) (n = 20) and dyspareunia (n = 8). 10 cases had proximal diverticula, 10 cases had multiple diverticula, and 35 cases had horseshoe/circumferential diverticula. Postoperatively, the recurrence rate was 19.7 %. Preoperative SUI disappeared in 14 cases, and de novo SUI was developed in six cases. One case developed urethral stricture, and no cases reported urinary fistula. Among 60 cases with pathological results, neoplastic change was seen in one case (1.7 %). Besides, atypical hyperplasia (n = 2) and metaplasia (n = 3) were observed. Univariate analysis suggested that age, duration, follow-up, diverticula size and diverticula shape were not associated with surgical outcomes. Patients with multiple diverticula (p = 0.032), proximal diverticula (p = 0.042) and those with previous urethral procedures (p = 0.004) were at risk of recurrent diverticula confirmed by multivariate logistic regression analysis.
The surgical outcomes of urethral diverticulectomies were acceptable. Multiple diverticula, proximal diverticula and previous urethral surgery were three independent risk factors for recurrent diverticula.
KeywordsUrethral Diverticula Risk factor Recurrence
This work was supported by Grant Nos. 81300579, 31370951, 81470927 and 81300579 from the National Natural Science Foundation of China, Grant No. JH2015017 from the Applied Key Project of Sichuan Province, Grant No. JH2014053 from the Foundation for Reserve Candidates of Science and Technology leader of Sichuan Province and Grant No. 2014SCU04B21 from the Foundation for Outstanding Young in Sichuan University, Grant No. 2014SZ0028 from the Support Project of the Ministry of Science and Technology of Sichuan Province and 1.3.5. Project for disciplines of excellence, West China Hospital, Sichuan University.
Liang Zhou was involved in data collection, data analysis, manuscript writing and follow-up. De-Yi Luo was involved in data collection and manuscript writing. Shi-Jian Feng took part in data analysis. The pathological data and imaging data were collected by Qi Liu and Xin Wei, respectively. Yi-Fei Lin and Tao Jin were involved in follow-up. Hong Li participated in manuscript revision. Kun-Jie Wang took part in project development and manuscript revision. Hong Shen was involved in project development, manuscript revision and performing surgeries.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.