Pathological features and chronic infection of female urethral diverticulum
Objective To explore the clinical classification,diagnosis and treatment of female urethral diverticulum(FUD),and to provide a basis for the etiological research and reasonable diagnosis and treatment of female urethral diverticulum.Methods From Jan.2011 to Dec.2022,29 female patients with FUD were treated in the Department of Urology,the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen Memorial Hospital of Sun Yat-sen University.Case data of the patients with FUD were reviewed,and the therapeutic effect was summarized.Patients were classified into simple diverticulum(extend around the urethra＜180°)(n=18)and complex(extend around the urethra＞180°,horseshoe shape or circumferential)(n=1 1).All patients underwent diverticulectomy and perioperative prophylactic anti-infection treatment.The preoperative clinical manifestations,pathological examination results and postoperative review results were analyzed.Results The positive rates of frequent urination,dysuria,recurrent urinary tract infection,stress urinary incontinence and leukocytosis were significantly different between simple FUD and complicated FUD.The difference was statistically significant(P＜0.1).The patient underwent transvaginal urethral diverticulectomy and perioperative prophylactic anti-infection treatment.The follow-up one month after discharge showed that the treatment was significantly correlated with the relief of symptoms of dysuria,and stress urinary incontinence.The difference was statistically significant(P＜0.05).Epithelial loss and atypical hyperplasia were more common in complex diverticulum,and urethral transitional epithelium with inflammatory cell infiltration was more common in simple diverticulum.The difference was statistically significant(P＜0.05).Conclusions The classification of female urethral diverticulum by MRI can guide clinical diagnosis and treatment.The use of antibiotics to control the infection and surgical removal of the diverticulum sac and closure of the diverticulum neck can effectively relieve the symptoms.
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