Conundrums in Urethral Diverticula-Conundrums in Urethral Diverticula

Video Transcription

Video Summary

In this video, Dr. Sandeep Vasavada, an expert in urology and female pelvic surgery at the Cleveland Clinic, discusses the challenges and considerations in the management of urethral diverticula. He emphasizes the importance of individualized management and highlights the success of a colleague using a transurethral approach and end-to-end urethroplasty for circumferential diverticula. For anterior diverticula, he suggests that a Martius flap may be beneficial but not routinely necessary. The recurrence rates of diverticula are around 5 to 15%, and routine imaging is not prioritized for asymptomatic patients. Complications such as fistula formation, stress incontinence, and strictures are discussed, and meticulous reconstruction techniques are recommended to minimize these complications. The use of synthetic slings in conjunction with diverticulectomy is also discussed, with a suggestion that a fascia sling may be more appropriate to avoid complications if incontinence is present. The video concludes with reflections on the speaker's experience and insights into their surgical approach and decision-making process.<br /><br />The video provides valuable information on the diagnosis, surgical techniques, and management of urethral diverticula, delivered by an experienced and renowned expert in the field.

Asset Subtitle

Sandip P. Vasavada, MD

Keywords

urology

female pelvic surgery

urethral diverticula

individualized management

transurethral approach

end-to-end urethroplasty

Martius flap

recurrence rates

complications

synthetic slings