{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:40:33Z","timestamp":1782175233306,"version":"3.54.5"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Urol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>There is no consensus between urologists on the diagnosis and treatment of female urethral diverticula. Once the diagnosis has been established, the most common treatment approach is surgical excision and reconstruction. Whether a staged procedure or simultaneous management is more appropriate for treating concomitant urethral diverticula and stress urinary incontinence remains controversial.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 63-year-old woman was hospitalized for repeated frequent urination, urgent urination, odynuria, and dysuria accompanied by intermittent overflow urinary incontinence for over 10\u2009years. She had a 5 year history of urinary stress incontinence prior to onset of these symptoms and had had four urethral caruncles resected on four separate occasions. There was visible leakage of urine when abdominal pressure was increased during physical examination and urodynamic studies. Additionally, turbid urine was discharged when the anterior vaginal wall was squeezed. Cystourethrography showed circumferential filling with contrast and multiple bladder diverticulae in the mid plane of the pubic symphysis. Urethrocystoscopy showed an orifice to a diverticulum at 7 o\u2019clock in the proximal urethra, into which an F19.8 urethroscope could be inserted, enabling examination of most of the diverticulae. The urethral diverticulae were resected, followed by mesh reconstruction of the urethra. During a 20-month follow-up, the treatment outcomes were satisfactory.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We here report a case of a giant circumferential urethral diverticulum combined with stress urinary incontinence that was successfully managed by an uncommon surgical reconstructive technique: a minimally invasive \u201cSandwich\u201d mesh repair procedure utilizing synthetic mesh wrap in the midurethral region.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12894-020-00598-2","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T14:57:11Z","timestamp":1585839431000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cSandwich\u201d mesh reconstruction of female giant urethral diverticulum: a case report"],"prefix":"10.1186","volume":"20","author":[{"given":"Juanjuan","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"key":"598_CR1","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1097\/01.AOG.0000124848.63750.e6","volume":"103","author":"JG Blaivas","year":"2004","unstructured":"Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G. Periurethral masses: etiology and diagnosis in a large series of women. Obstet Gynecol. 2004;103:842\u20137.","journal-title":"Obstet Gynecol"},{"key":"598_CR2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1080\/2090598X.2019.1589748","volume":"17","author":"AK Greiman","year":"2019","unstructured":"Greiman AK, Rolef J, Rovner ES. Urethral diverticulum: a systematic review. Arab J Urol. 2019;17:49\u201357.","journal-title":"Arab J Urol"},{"key":"598_CR3","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1002\/nau.23334","volume":"37","author":"A Greiman","year":"2018","unstructured":"Greiman A, Rittenberg L, Freilich D, Rames R, El-Zawahry A, Koski M, et al. Outcomes of treatment of stress urinary incontinence associated with female urethral diverticula: a selective approach. Neurourol Urodyn. 2018;37:478\u201384.","journal-title":"Neurourol Urodyn"},{"key":"598_CR4","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s11934-015-0540-8","volume":"16","author":"IM Crescenze","year":"2015","unstructured":"Crescenze IM, Goldman HB. Female urethral diverticulum: current diagnosis and management. Curr Urol Rep. 2015;16:71.","journal-title":"Curr Urol Rep"},{"key":"598_CR5","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.1016\/j.juro.2008.07.049","volume":"180","author":"K Stav","year":"2008","unstructured":"Stav K, Dwyer PL, Rosamilia A, Chao F. Urinary symptoms before and after female urethral diverticulectomy--can we predict de novo stress urinary incontinence? J Urol. 2008;180:2088\u201390.","journal-title":"J Urol"},{"key":"598_CR6","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/S0039-6109(16)35835-2","volume":"39","author":"M Mackinnon","year":"1959","unstructured":"Mackinnon M, Pratt JH, Pool TL. Diverticulum of the female urethra. Surg Clin North Am. 1959;39:953\u201362.","journal-title":"Surg Clin North Am"},{"key":"598_CR7","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/luts.12008","volume":"5","author":"JH Kim","year":"2013","unstructured":"Kim JH, Lee KW, Kim JM, Kim ME, Kim YH. Risk factors for De novo mixed urinary incontinence and stress urinary incontinence following surgical removal of a urethral diverticulum. Low Urin Tract Symptoms. 2013;5:154\u20138.","journal-title":"Low Urin Tract Symptoms."},{"key":"598_CR8","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1016\/j.juro.2010.02.2369","volume":"183","author":"RR Dmochowski","year":"2010","unstructured":"Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183:1906\u201314.","journal-title":"J Urol"},{"key":"598_CR9","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1016\/j.urology.2015.02.022","volume":"85","author":"E Enemchukwu","year":"2015","unstructured":"Enemchukwu E, Lai C, Reynolds WS, Kaufman M, Dmochowski R. Autologous Pubovaginal sling for the treatment of concomitant female urethral diverticula and stress urinary incontinence. Urology. 2015;85:1300\u20133.","journal-title":"Urology."},{"key":"598_CR10","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/j.1757-5672.2009.00058.x","volume":"2","author":"YL Chang","year":"2010","unstructured":"Chang YL, Lin AT, Chen KK, Chang LS. Simultaneous treatment of female urethral diverticulum and stress urinary incontinence with urethral Diverticulectomy and suburethral synthetic mesh sling. Low Urin Tract Symptoms. 2010;2:22\u20136.","journal-title":"Low Urin Tract Symptoms"}],"container-title":["BMC Urology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-020-00598-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12894-020-00598-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-020-00598-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T00:23:17Z","timestamp":1616199797000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcurol.biomedcentral.com\/articles\/10.1186\/s12894-020-00598-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["598"],"URL":"https:\/\/doi.org\/10.1186\/s12894-020-00598-2","relation":{},"ISSN":["1471-2490"],"issn-type":[{"value":"1471-2490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,20]]},"assertion":[{"value":"7 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study complies with all relevant ethical considerations. Written informed consent was obtained from the patient.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}