Experience in conversion of symptomatic urethral diverticulum to asymptomatic status through surgery

Abstract

Abstract Symptomatic urethral diverticulum (UD) is a rare disease typically treated with complete surgical resection, which often involves significant trauma and higher postoperative complication rates. This study introduces a surgical concept to convert “Symptomatic” UD into “Asymptomatic” UD. In our study, we retrospectively analyzed 21 symptomatic female UD patients treated at our center between January 2018 and May 2023, collecting baseline demographic and clinical data. All patients underwent diverticulectomy or partial resection and were followed postoperatively. Mean surgery time was 75.67 ± 28.85 min, with an average blood loss of 25.52 ± 10.69 ml. The median hospital stay was 6 days (interquartile range 3.5–7 days), and the median catheterization time was 15 days (interquartile range 14–21 days). According to the Clavien–Dindo classification, most complications were minor (Grade 1 = 2 patients, Grade 2 = 1 patient, above Grade 3a = 1 patient). Pre- and post-operation UDI-6 and QoL questionnaires showed that symptoms involved in Q1–4 all improved after surgery (P < 0.05) and quality of life score also increased (P < 0.05). The "symptom cure rate" reached 76.2%, suggesting that our surgical approach may offer a minimally invasive and effective option for managing UD.

Keywords

• Urethral diverticulum
• Asymptomatic
• Stress urinary incontinence
• Symptom cure rate
• Complications