Mercy Hospital for Women, Melbourne, Victoria, Australia.
North Shore Hospital, Auckland, New Zealand.
Int Urogynecol J. 2020 Dec;31(12):2679-2681. doi: 10.1007/s00192-020-04357-7. Epub 2020 Jun 3.
Recurrent urethral diverticulum has been reported in 23% of cases after primary repair and can be difficult to manage. The aim of this video is to demonstrate a surgical technique of repairing a recurrent diverticulum in a woman who had two previous procedures, one with a Martius labial fat pad graft.
A 40-year-old woman presented with a symptomatic recurrent urethral diverticulum after two previous repairs. She underwent surgery with excision of the diverticular mucosa and multilayer urethral closure using the diverticulum wall after mobilization and then repositioning of the Martius labial fat pad interposition.
There were no surgical complications intra- or postoperatively, and the patient had improvement of her symptoms postoperatively with resolution of the diverticulum on ultrasound.
Mobilizing and repositioning a Martius labial fat pad is a feasible technique for complex recurrent urethral diverticulum repairs. The graft alone without meticulous urethral repair will not prevent diverticulum recurrence, fistula formation or stress urinary incontinence. This procedure requires experienced surgeons to minimize surgical complications and optimize outcome.
初次修复后，有 23%的病例会出现复发性尿道憩室，这可能难以处理。本视频旨在演示一种手术技术，用于治疗一名曾接受过两次手术的女性的复发性憩室，其中一次采用了 Martius 阴唇脂肪垫移植物。
一名 40 岁女性在两次修复后出现有症状的复发性尿道憩室。她接受了手术，切除憩室黏膜，在移动和重新定位 Martius 阴唇脂肪垫移植物后，使用憩室壁进行多层尿道闭合。
术中及术后均无手术并发症，患者术后症状改善，超声显示憩室消失。
移动和重新定位 Martius 阴唇脂肪垫是一种用于治疗复杂复发性尿道憩室的可行技术。单纯的移植物而不进行精细的尿道修复不会防止憩室复发、瘘管形成或压力性尿失禁。该手术需要经验丰富的外科医生来最小化手术并发症并优化结果。
