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Predictive value of urethral sphincter complex volume for persistent high voiding pressure in female urethral diverticulum patients post-diverticulectomy
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Predictive value of urethral sphincter complex volume for persistent high voiding pressure in female urethral diverticulum patients post-diverticulectomy
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Predictive value of urethral sphincter complex volume for persistent high voiding pressure in female urethral diverticulum patients post-diverticulectomy
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Journal Article
Predictive value of urethral sphincter complex volume for persistent high voiding pressure in female urethral diverticulum patients post-diverticulectomy
2025
Overview
Purpose
This study evaluated the relationship between urethral diverticulum volume (UDv), urethral sphincter complex volume (USCv), clinical and urodynamic characteristics, and surgical outcomes in women with UD.
Methods
A retrospective study was conducted on 53 female patients who underwent diverticulectomy for UD. They were divided into two groups: proximal/middle UD (pmUD,
n
= 43) and distal UD (dUD,
n
= 10). Preoperative assessments included videourodynamic study (VUDS) and magnetic resonance imaging, with a follow-up VUDS 1 month post-surgery.
Results
Compared to the dUD group, pmUD patients were less likely to present with a vaginal lump (37.2% vs. 80.0%,
p
= 0.031) but had significantly larger USCv (9.96 ± 5.91 cm
3
vs. 5.23 ± 1.19 cm
3
,
p
< 0.001) and UDv (6.27 ± 7.40 cm
3
vs. 0.84 ± 0.81 cm
3
,
p
< 0.001). The pmUD patients had longer surgeries and higher recurrence rates (32.6% vs. 0%,
p
= 0.018). In the pmUD group, 24 patients had bladder outlet obstruction (BOO) and 25 exhibited high-pressure voiding (> 20cmH
2
O). No significant association was found between UDv or USCv and recurrence, unresolved BOO, or high-pressure voiding status. However, a USCv cutoff of ≥ 8.2 cm
3
was identified, predicting unresolved high-pressure voiding status post-surgery (
p
= 0.023). Additionally, 9.3% pmUD patients developed de novo stress urinary incontinence, correlated with larger UDv (11.5 ± 14.3 cm
3
vs. 5.9 ± 6.4 cm
3
,
p
= 0.02).
Conclusion
A USCv cutoff of ≥ 8.2 cm
3
was identified as a predictor for unresolved high-pressure voiding after diverticulectomy.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Aged
/ Diverticulum - complications
/ Diverticulum - physiopathology
/ Female
/ Humans
/ Medicine
/ Oncology
/ Patients
/ Postoperative Complications - physiopathology
/ Pressure
/ Surgery
/ Urethra - diagnostic imaging
/ Urethral Diseases - complications
/ Urethral Diseases - pathology
/ Urethral Diseases - physiopathology
/ Urology
