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An Eight-Year Experience of Transvaginal Urethral Diverticulectomy: A Single-Center Study
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Hyeon Woo Kim, Jeong Zoo Lee, Yangkyu Park, Dong Gil Shin
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Urogenit Tract Infect 2022;17(3):89-95. Published online December 31, 2022
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DOI: https://doi.org/10.14777/uti.2022.17.3.89
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 Abstract
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- Purpose: This study aimed to analyze and report the surgical outcomes in female patients with urethral diverticulum (UD) over an eight-year period at a single center.
Materials and Methods: Data of 49 UD females who underwent transvaginal urethral diverticulectomy between October 2011 and December 2019 were collected. The characterization of UD was reviewed using pelvic imaging studies. The pre- and post-operative symptoms, post-operative complications, and pathological findings were analyzed by reviewing the medical records.
Results: The most frequent pre-operative symptom was dysuria (n=18), followed by incontinence (n=14), and these symptoms persisted until 3 months post-operatively in one and six patients, respectively. Pre-operative incontinence was cured in eight patients; however, de novo stress urinary incontinence occurred in five patients within a month after surgery. Submucosal macroplastique injection was administered to these patients; of whom, one was cured and three showed an improvement. Recurrent UD was found in seven patients at a mean of 14.14±17.21 months post-operatively, and a repeat diverticulectomy was performed in six of them; of these, one recurred again and was cured after the third diverticulectomy. Urethral strictures were observed in two patients within a month after the operation but improved after urethral dilatation. Bleeding and surgical site infections were observed in one and two patients, respectively, but were successfully managed conservatively. According to the pathological report, only one was diagnosed with urethral adenocarcinoma.
Conclusions: Transvaginal urethral diverticulectomy can effectively manage UD, and its post-operative complications can be successfully managed by a proper treatment.
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Pregnancy and Urinary Tract Infection
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Tae Nam Kim, Dong Gil Shin, Sang Don Lee, Jeong Zoo Lee
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):141-149. Published online October 31, 2009
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Abstract
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- Urinary tract infections (UTIs) represent the most common bacterial infection in pregnant and non-pregnant women. Physiologic changes of pregnancy increase a woman’s susceptibility to UTIs. Progesterone effects and mechanical compression by the gravid uterus impair emptying of the bladder and lead to increased bladder residual volume and vesicoureteral reflux. Relative stasis of urine in the ureters results in hydronephrosis. Furthermore, pregnancy-related changes in glomerular filtration rate increases the urinary glucose concentration and alkalinity, thereby facilitating bacterial growth. The signs and symptoms of UTIs vary by the type of infection. UTIs in pregnancy is classified by the site of bacterial proliferation as follows: asymptomatic bacteriuria, cystitis, pyelonephritis.
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Effect of Associated Diseases to Renal and Perirenal Abscesses
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Dong Gil Shin, Hong Koo Ha, Jae Min Chung, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2009;4(2):202-209. Published online October 31, 2009
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- "Purpose: We analyzed the clinical experiences of patients with renal and perirenal abscesses during the last 10 years according to associated diseases. Materials and Methods: We reviewed the medical records of 63 patients with renal, perirenal, and mixed abscesses treated at two hospital from January 1999 to August 2009. The patients were divided into 3 groups: group A consisted of 11 patients without associated diseases, group B consisted of 31 patients with nonurological associated diseases and group C consisted of 21 patients with urological associated diseases. Results: A male to female sexual ratio of 63 patients was 1:2, and the mean age was 51.4±15.2 years, respectively. The most common associated diseases were diabetes mellitus (39.7%) and liver disease (19.0%). The most common urological associated diseases were nephrolithiasis (11.1%) and ureteral obstruction (7.9%). Fever or flank pain were the common symptom. The most common isolated uropathogen in urine, blood and pus culture was E. coli. The hospitalized, clinical and laboratory improvement duration of group A was significantly shorter than group B and C, respectively. The hospitalized, clinical and laboratory improvement duration was not significantly different between group B and C. Most patients are cured or improved on discharge from hospital in all abscesses. Conclusions: We suggest that the renal and perirenal abscesses with associated diseases needs longer hospitalized days and more intensive treatment than that without associated diseases."
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