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KMID : 0978920020030040041
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Korean Journal of Clinical Geriatrics
2002 Volume.3 No. 4 p.41 ~ p.47
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Effects of pubovaginal sling and martius labial fat pad interposition after female urethral diverticulectomy
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Han Keo-Reum
Lee You-Sik
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Abstract
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Purpose: To evaluate the effects of pubovaginal sling (PVS) and Martius labial fat pad interposition (MLFI) upon patients with female urethral diverticulum after diverticulectomy.
Materials and methods: Total 23 consecutive cases of urethral diverticulum were reviewed retrospectively. The pre-operative evaluation included a history, physical examination, voiding cystourethrogram, cystoscopy, transperineal ultrasound and urodynamic study to investigate the urethral function and concomitant stress urinary incontinence. Treatment consisted of transvaginal diverticulectomy alone or with PVS only or combined with MLFI.
Results: The presenting symptoms were palpable vaginal mass (52.2% of cases), urinary incontinence (52.2%). frequency/urgency (30.4%) and pain (21.7%). All patients were treated with surgical procedure. Transvaginal diverticulectomy alone was performed using a 3-layer closure in nine women (39.1%) and concomitant PVS with diverticulectomy in eight women (34.8%) with stress urinary incontinence. MLFI combined with the above procedure was performed in six women (26.l %) with large defect of urethra after resection of diverticulum. None of the women who underwent diverticulectomy with or without PVS and MLFI had urethrovaginal fistula, recurrent diverticulum or postoperative incontinence.
Conclusions: In complicating cases, simultaneous transvaginal diverticulectomy, pubovaginal sling and Martius labial fat pad interposition can be performed safely and effectively.
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KEYWORD
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Female urethral diverticulum, Pubovaginal sling, Martius labial
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