{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:40:20Z","timestamp":1790228420886,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T00:00:00Z","timestamp":1562112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the incidence and management of urodynamic stress urinary incontinence (USUI) in women undergoing transvaginal excision of a urethral diverticulum (UD) at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective database, capturing patients undergoing urethral diverticulectomy over a 9\u2010year period (May 2007 to August 2016), was reviewed focusing on USUI and subsequent management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred patients underwent UD excision (with modified Martius labial fat\u2010pad flap interposition). Preoperative magnetic resonance imaging data, available in 90 patients, demonstrated that 80% had complex diverticula. Complete urodynamic data were available for 93 patients.<\/jats:p><jats:p>Preoperatively, 27 patients (29%) had USUI of which 16 patients resolved with either UD excision alone (n\u2009=\u20098) or 3 months of pelvic floor muscle therapy (PFMT) (n\u2009=\u20098). All 11 with persistent postoperative USUI had video urodynamics (VUDs) confirming Blaivas type 3 USUI. Six patients had a rectus fascial pubovaginal sling (RFPVS) with success in five (83.3%) while five had a mid\u2010urethral obturator tape (MUT\u2010O) with 100% success.<\/jats:p><jats:p>Sixteen patients developed de novo stress urinary incontinence (SUI) postoperatively, with resolution after PFMT in 12 (75%). VUDS identified USUI (Blaivas type 3) in two (of the remaining four) patients, managed successfully with MUT\u2010O (n\u2009=\u20091) and RFPVS (n\u2009=\u20091).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative USUI is present in 29% with UD. Postoperatively, 35.5% (n\u2009=\u200933) have pre\u2010existing (19) or de novo (14) SUI, of which 60.6% (n\u2009=\u200920) resolves after 12 months of conservative management. Surgery for USUI is required in 13 (13.9%), with cure in 92.3%. This supports our practice to excise UD primarily and delay USUI surgery, therefore, avoiding overtreatment for the majority.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24090","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T04:18:30Z","timestamp":1562213910000},"page":"1889-1900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The incidence and outcomes of urodynamic stress urinary incontinence in female patients with urethral diverticulum"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6836-2118","authenticated-orcid":false,"given":"Rachel","family":"Barratt","sequence":"first","affiliation":[{"name":"Department of Urology UCLH  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3712-9460","authenticated-orcid":false,"given":"Sachin","family":"Malde","sequence":"additional","affiliation":[{"name":"Department of Urology Guys and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahreen","family":"Pakzad","sequence":"additional","affiliation":[{"name":"Department of Urology UCLH  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan","family":"Hamid","sequence":"additional","affiliation":[{"name":"Department of Urology UCLH  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-9826","authenticated-orcid":false,"given":"Jeremy","family":"Ockrim","sequence":"additional","affiliation":[{"name":"Department of Urology UCLH  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9074-7604","authenticated-orcid":false,"given":"Tamsin","family":"Greenwell","sequence":"additional","affiliation":[{"name":"Department of Urology UCLH  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"key":"e_1_2_7_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)66126-3"},{"issue":"3","key":"e_1_2_7_1_3_1","first-page":"107","article-title":"Diagnostic and therapeutic aspects of suburethral diverticuli. 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