尿道-括約肌綜合體應用於預測尿道憩室切除術後殘餘憩室

潘柏勳¹、范玉華^1,2、黃志賢^1,2

¹台北榮民總醫院 泌尿部；²國立陽明交通大學醫學院泌尿學科，書田泌尿科學研究中心

Urethra-sphincter complex volume predictive of residual diverticulum after diverticulectomy

Po-Hsun Pan¹, Yu-Hua Fan^1,2, William J.S. Huang^1,2

¹Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan

²Department of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

Purpose:

We aimed to evaluate the correlation between urethra-sphincter complex volume (USCv), size of urethra diverticulum (UD), urodynamic characteristics, and treatment outcomes in women with UD.

Materials and Methods:

We retrospectively reviewed the medical records of women with symptomatic UD who underwent diverticulectomy between 2005 and 2020. Lower urinary tract symptoms were evaluated by quantitative questionnaires including International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS) and Urogenital Distress Inventory-6 (UDI-6). All patients underwent magnetic resonance imaging (MRI) and videourodynamic study (VUDS) prior to surgery, and postoperative evaluation with VUDS. The urethra‐sphincter complex was measured using

T2‐weighted MRI, and the USCv was determined by the subtraction of UD volume from whole urethra volume.

Results:

We enrolled 27 female patients in this study with mean age of 47.93 years old. The mean USCv and UD volume were 7.59 ± 2.61 cm3 and 4.97 ± 5.74 cm3. In these patients, 29.63% (8/27) had the history of recurrent urinary tract infection (rUTI). Patients with rUTI had larger USCv (9.35 ± 3.58 cm3 vs. 6.68 ± 1.67 cm3, p = 0.037) and larger UD (8.85 ± 8.79 cm3 vs. 2.97 ± 2.17 cm3, p = 0.031). There were 39.1% (9/23) patients with residual diverticulum after diverticulectomy. Patients with larger USCv had a higher probability of residual diverticulum after surgery (7.98 ± 0.55 cm3 vs. 6.26 ± 0.48 cm3, p = 0.046). Besides, The ROC curve showed a correlation between USCv and the size of UD (correlation coefficient, r = 0.758, p < 0.001). However, there was no statistically significant correlation between USCv, lower urinary tract symptoms and VUDS parameters.

Conclusions:

USCv correlates to the size of UD and predicts the residual diverticulum after diverticulectomy.