Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients
Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients
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DOI：
10.1007/s00345-016-1815-5
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发表时间：
2016
影响因子：
3.4
通讯作者：
Liang Zhou;D. Luo;Shi-jian Feng;Xin Wei;Qi Liu;Yifei Lin;Tao Jin;Hong Li;Kun-jie Wang;Hong Shen
中科院分区：
文献类型：
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作者：
Liang Zhou;D. Luo;Shi-jian Feng;Xin Wei;Qi Liu;Yifei Lin;Tao Jin;Hong Li;Kun-jie Wang;Hong Shen
PurposeWe旨在报告女性尿道憩室的手术结果，并探讨憩室复发的危险因素。方法从2009年1月至2015年10月，共有66例患者接受了尿道憩室切除术。收集患者和憩室特征。平均随访28.8个月（范围4-85个月）。复发被定义为需要重复憩室切除术。ResultsMean age was 44.9 years.平均症状持续时间为28.1个月。7例有尿道手术史。平均憩室大小为2.8 cm。主要临床症状为尿流不止41例，阴道包块41例，排尿困难33例，尿频尿急29例，感染24例，压力性尿失禁20例，性交困难8例。近端憩室10例，多发憩室10例，马蹄形/环形憩室35例。术后复发率为19.7%。术前SUI消失14例，新发SUI 6例。1例发生尿道狭窄，无尿瘘发生。60例有病理结果的患者中，1例（1.7%）出现肿瘤性改变.此外，还观察到不典型增生（n= 2）和化生（n= 3）。单因素分析显示，年龄、病程、随访、憩室大小和形状与手术结果无关。多发性憩室（p= 0.032），近端憩室（p= 0.042）和以前的尿道手术（p= 0.004）的患者复发憩室的风险证实了多因素Logistic回归analysis.ConclusionsThe尿道憩室切除术的手术结果是可以接受的。多发性憩室、近端憩室和既往尿道手术史是憩室复发的3个独立危险因素。
PurposeWe aimed to report surgical outcomes in female urethral diverticula and to investigate the risk factors for diverticula recurrence.MethodsA 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.ResultsMean 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.ConclusionsThe surgical outcomes of urethral diverticulectomies were acceptable. Multiple diverticula, proximal diverticula and previous urethral surgery were three independent risk factors for recurrent diverticula.