Transvaginal urethral diverticulectomy using small intestinal submucosa interposition graft

Background. Our aim was to evaluate our four and a half year single-center experience with interposition of small intestinal submucosa (SIS) in transvaginal urethral diverticulectomy. Design and methods. We reviewed the records of all patients who underwent a transvaginal diverticulectomy at our center between September 2006 and December 2010. Collected data included demographic details, symptoms, diagnosis, treatment, follow-up, and outcome. Mean time of follow-up was 127 days. Results. Twelve consecutive patients were identified. Mean age was 36 years. Most reported symptoms were a vaginal mass and pain, recurrent urinary tract infections, and urinary stress incontinence. At physical examination a vaginal mass was palpated in all cases. In two out of seven patients cystourethroscopy showed the diverticulum. Magnetic resonance imaging was diagnostic in five out of ten patients who underwent this examination. In all patients a transvaginal diverticulectomy with SIS interposition was performed. In one patient the postoperative course was complicated by a minor postoperative bleeding that needed re-intervention. Two patients developed de novo urinary stress incontinence after surgery. No symptoms of diverticulum recurrence, urethrovaginal fistula, urethral stricture or voiding difficulties were reported. Conclusions. We conclude that SIS is efficient and safe to use as interposition graft in transvaginal urethral diverticulectomy.