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Video and review of the surgical management of recurrent urethral diverticulum

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Abstract

Introduction

Recurrent urethral diverticulum has been reported in 23% of cases after primary repair and can be difficult to manage. The aim of this video is to demonstrate a surgical technique of repairing a recurrent diverticulum in a woman who had two previous procedures, one with a Martius labial fat pad graft.

Methods

A 40-year-old woman presented with a symptomatic recurrent urethral diverticulum after two previous repairs. She underwent surgery with excision of the diverticular mucosa and multilayer urethral closure using the diverticulum wall after mobilization and then repositioning of the Martius labial fat pad interposition.

Results

There were no surgical complications intra- or postoperatively, and the patient had improvement of her symptoms postoperatively with resolution of the diverticulum on ultrasound.

Conclusions

Mobilizing and repositioning a Martius labial fat pad is a feasible technique for complex recurrent urethral diverticulum repairs. The graft alone without meticulous urethral repair will not prevent diverticulum recurrence, fistula formation or stress urinary incontinence. This procedure requires experienced surgeons to minimize surgical complications and optimize outcome.

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Author information

Authors and Affiliations

  1. Mercy Hospital for Women, Melbourne, Victoria, Australia

    N. Dykes, P. Dwyer & A. Zilberlicht

  2. North Shore Hospital, Auckland, New Zealand

    N. Dykes

  3. Monash Medical Centre, Melbourne, Victoria, Australia

    A. Rosamilia

Authors
  1. N. Dykes
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  2. P. Dwyer
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  3. A. Rosamilia
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  4. A. Zilberlicht
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Contributions

N Dykes: Video recording and editing, manuscript writing.

P Dwyer: Surgeon in recording, manuscript editing.

A Rosamilia: Surgeon in recording.

A Zilberlicht: Video editing.

Corresponding author

Correspondence to N. Dykes.

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None.

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Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Dykes, N., Dwyer, P., Rosamilia, A. et al. Video and review of the surgical management of recurrent urethral diverticulum. Int Urogynecol J 31, 2679–2681 (2020). https://doi.org/10.1007/s00192-020-04357-7

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  • DOI: https://doi.org/10.1007/s00192-020-04357-7

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