Department of Surgery, University of Alberta Faculty of Medicine and Dentistry, Edmonton, and the Department of Surgery and the Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Vesia [Alberta Bladder Centre], Southern Alberta Institute of Urology, Calgary, Alberta, Canada.
Obstet Gynecol. 2022 Nov 1;140(5):778-783. doi: 10.1097/AOG.0000000000004956. Epub 2022 Oct 5.
To describe the etiology and presenting symptoms of periurethral and anterior vaginal wall masses in a large series of patients in an academic institution.
A retrospective chart review of 126 patients presenting and undergoing treatment for periurethral and anterior vaginal wall masses between November 2001 and July 2021 was completed. Clinicopathologic data were extracted. Ethics approval was obtained. The primary objective of this study was to determine the etiology of these masses; secondary objectives included determining the rates of presenting symptoms, complications, resolution of stress urinary incontinence (SUI), and de novo SUI.
The median age of patients was 42 years. The most common etiology was urethral diverticula (39.7%), followed by Skene gland cysts or abscesses (30.2%). The rate of malignancy was 1.6%, and the rate of infection was 21.4%. The most common presenting symptoms were sensation of mass (78.6%), dyspareunia (52.4%), and discharge (46.0%). The rate of surgical complications was 9.5%. Three patients had recurrence on follow-up, but there were no recurrent urethral diverticula after excision. The rate of de novo SUI was 5.6%. The rate of resolution of SUI was 67.6%, and all patients who had slings reported resolution of SUI.
Urethral diverticula and Skene gland cysts or abscesses accounted for 70% of periurethral and anterior vaginal wall masses in this series. Treatment by complete excision is usually successful.
在一家学术机构的大量患者中描述尿道周围和阴道前壁肿块的病因和临床表现。
对 2001 年 11 月至 2021 年 7 月期间因尿道周围和阴道前壁肿块就诊并接受治疗的 126 例患者进行回顾性图表审查。提取临床病理数据。获得伦理批准。本研究的主要目的是确定这些肿块的病因；次要目标包括确定出现症状、并发症、压力性尿失禁（SUI）的缓解率和新发 SUI 的发生率。
患者的中位年龄为 42 岁。最常见的病因是尿道憩室（39.7%），其次是斯基恩腺囊肿或脓肿（30.2%）。恶性肿瘤的发生率为 1.6%，感染率为 21.4%。最常见的临床表现为肿块感（78.6%）、性交困难（52.4%）和分泌物（46.0%）。手术并发症发生率为 9.5%。3 例患者在随访中复发，但切除后无尿道憩室复发。新发 SUI 的发生率为 5.6%。SUI 的缓解率为 67.6%，所有接受吊带手术的患者均报告 SUI 缓解。
在本系列中，尿道憩室和斯基恩腺囊肿或脓肿占尿道周围和阴道前壁肿块的 70%。完整切除通常可获得成功的治疗效果。
