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Robot-assisted laparoscopic anterior urethral diverticulectomy.

Publication ,  Journal Article
O'Shea, M; Routh, JC; Siddiqui, NY
Published in: Int Urogynecol J
February 2023

INTRODUCTION AND HYPOTHESIS: A 31-year-old patient with a history of fetal sacrococcygeal teratoma requiring tumor resection and pelvic reconstruction in infancy presented with a 3-year history of recurrent vulvar abscesses and voiding dysfunction. Magnetic resonance imaging demonstrated a fluid collection posterior to the pubic bone and inferior to the bladder. The objective was to demonstrate the key steps in the resection and repair of an anterior urethral diverticulum via robot-assisted laparoscopic approach. METHODS: Cystoscopy followed by robot-assisted laparoscopic retropubic dissection was used for resection of an anterior urethral diverticulum followed by urethral reconstruction. RESULTS: Cystoscopy revealed a large anterior cavity at the midpoint of the urethra consistent with an anterior urethral diverticulum. This likely tracked inferiorly toward her vulva during repeated episodes of infection expressing through her recurrent abscesses. Retropubic space exploration revealed dense fibrotic tissue adherent to the underside of the pubic tubercule contiguous with the anterior urethral diverticulum, which was successfully resected. CONCLUSIONS: Female anterior urethral diverticulum is a rare entity. A robot-assisted laparoscopic approach can be safely utilized to identify and resect an anterior urethral diverticulum. Key points include optimization of port placement, use of a council-tip catheter to facilitate bladder drainage in the setting of distorted pelvic anatomy, and multi-layered tension-free urethral closure with flap placement.

Duke Scholars

Published In

Int Urogynecol J

DOI

EISSN

1433-3023

Publication Date

February 2023

Volume

34

Issue

2

Start / End Page

589 / 592

Location

England

Related Subject Headings

  • Urethral Diseases
  • Urethra
  • Robotics
  • Obstetrics & Reproductive Medicine
  • Laparoscopy
  • Humans
  • Female
  • Diverticulum
  • Adult
  • Abscess
 

Citation

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Chicago
ICMJE
MLA
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O’Shea, M., Routh, J. C., & Siddiqui, N. Y. (2023). Robot-assisted laparoscopic anterior urethral diverticulectomy. Int Urogynecol J, 34(2), 589–592. https://doi.org/10.1007/s00192-022-05355-7
O’Shea, Michele, Jonathan C. Routh, and Nazema Y. Siddiqui. “Robot-assisted laparoscopic anterior urethral diverticulectomy.Int Urogynecol J 34, no. 2 (February 2023): 589–92. https://doi.org/10.1007/s00192-022-05355-7.
O’Shea M, Routh JC, Siddiqui NY. Robot-assisted laparoscopic anterior urethral diverticulectomy. Int Urogynecol J. 2023 Feb;34(2):589–92.
O’Shea, Michele, et al. “Robot-assisted laparoscopic anterior urethral diverticulectomy.Int Urogynecol J, vol. 34, no. 2, Feb. 2023, pp. 589–92. Pubmed, doi:10.1007/s00192-022-05355-7.
O’Shea M, Routh JC, Siddiqui NY. Robot-assisted laparoscopic anterior urethral diverticulectomy. Int Urogynecol J. 2023 Feb;34(2):589–592.
Journal cover image

Published In

Int Urogynecol J

DOI

EISSN

1433-3023

Publication Date

February 2023

Volume

34

Issue

2

Start / End Page

589 / 592

Location

England

Related Subject Headings

  • Urethral Diseases
  • Urethra
  • Robotics
  • Obstetrics & Reproductive Medicine
  • Laparoscopy
  • Humans
  • Female
  • Diverticulum
  • Adult
  • Abscess