Role of urodynamics in management of urethral diverticulum in females

Few studies have focused on the urodynamic findings of urethral diverticula (UD). We characterized the symptoms and urodynamic findings in women with UD.

A retrospective review of all women in a single center having surgical treatment for symptomatic UD between May 2004 and September 2014 was done. Lower urinary tract symptoms were evaluated with International Prostate Symptom Score and Overactive Bladder Symptom Score questionnaires. All patients underwent magnetic resonance imaging and videourodynamic study (VUDS) prior to surgery, and postoperative evaluation with VUDS.

A total of 20 female patients were enrolled into the study. 12 (60%) UD patients presented with symptoms of stress urinary incontinence (SUI). However, there were merely 3 (15%) patients diagnosed as urodynamic SUI. 15 (75%) patients exhibited low catheter-free uroflow. Detrusor overactivity was demonstrated in 4 (20%) patients. Bladder outlet obstruction (BOO) was diagnosed in 8 (40%) cases. Postoperative VUDS revealed persistent BOO in 50% of patients with preoperative BOO. Of these, residual diverticulum was noted by VUDS in one patient.

For UD patients with urinary incontinence or voiding dysfunction, VUDS is helpful in accurately characterizing these symptoms.

Journal of the Chinese Medical Association : JCMA. 2017 Aug 11 [Epub ahead of print]

Kuan-Jung Lin, Yu-Hua Fan, Alex Tong-Long Lin

Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC., Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Shu-Tien Urological Science Research Center, Taipei, Taiwan, ROC. Electronic address: ., Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Shu-Tien Urological Science Research Center, Taipei, Taiwan, ROC.