Skip to main content
Erschienen in: International Urogynecology Journal 8/2022

19.04.2021 | Original Article

Correlation between symptoms and imaging findings including pelvic floor ultrasound to improve the symptom-based diagnosis of female urethral diverticulum (CHECK-UD study)

verfasst von: Bara Barakat, Knut Franke, Sameh Hijazi, Ingmar Wolff, Boris Hadaschik, Christian Rehme

Erschienen in: International Urogynecology Journal | Ausgabe 8/2022

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

The objective was to establish a model to predict the presence of a female urethral diverticulum (UD) based on symptoms.

Methods

A prospective CHECK-UD study (check of female urethral diverticulum) was conducted. Female patients presenting with symptoms such as lower urinary tract symptoms (LUTS), postmicturition dribble or urinary incontinence (UI), dyspareunia or pain in the pelvic area, and recurrent urinary tract infection (UTI) treated between 2015 and 2020 were included. The association between each symptom variable and the positive finding of UD was evaluated by multivariate logistic regression adjusting for age, body mass index (BMI), vaginal deliveries, previous surgery for SUI, previous pelvic surgery, and microscopic hematuria. A predictive model for the presence of UD was then created.

Results

In total, 189 female patients with a minimum of one symptom were enrolled. Pelvic floor ultrasound revealed the presence of UD in 66 out of 189 (34.92%). Of the four symptoms, the combinations “LUTS + postmicturition dribble + UTI,” “postmicturition dribble + LUTS,” and “UTI + LUTS” were most significantly related to positive findings and had a higher positive prognostic value for the diagnosis of UD than each individual symptom alone (OR = 13.78 [95% CI: 6.95–16.35], p < 0.001; OR = 9.94 [95% CI: 4.60–12.2], p < 0.05; and OR = 5.78 [95% CI: 1.58–6.98] p = 0.05) respectively.

Conclusion

Based on our model, the combination “LUTS + postmicturition dribble + UTI” seems to be the most sensitive combination of clinical symptoms predicting the positive finding of UD. This model could be used for patient counseling and for the identification of patients with UD.
Literatur
1.
Zurück zum Zitat El-Nashar SA, Bacon MM, Kim-Fine S, Weaver AL, Gebhart JB, Klingele CJ. Incidence of female urethral diverticulum: a population-based analysis and literature review. Int Urogynecol J. 2014;25:73–9.CrossRef El-Nashar SA, Bacon MM, Kim-Fine S, Weaver AL, Gebhart JB, Klingele CJ. Incidence of female urethral diverticulum: a population-based analysis and literature review. Int Urogynecol J. 2014;25:73–9.CrossRef
2.
Zurück zum Zitat Stewart M, Bretland PM, Stidolph NE. Urethral diverticula in the adult female. Br J Urol. 1981;53:353–9.CrossRef Stewart M, Bretland PM, Stidolph NE. Urethral diverticula in the adult female. Br J Urol. 1981;53:353–9.CrossRef
3.
Zurück zum Zitat Romanzi LJ, Groutz A, Blaivas JG. Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement. J Urol. 2000;164:428–4.CrossRef Romanzi LJ, Groutz A, Blaivas JG. Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement. J Urol. 2000;164:428–4.CrossRef
4.
Zurück zum Zitat Reeves FA, Inman RD, Chapple CR. Management of symptomatic urethral diverticula in women: a single-centre experience. Eur Urol. 2014;66:164–72.CrossRef Reeves FA, Inman RD, Chapple CR. Management of symptomatic urethral diverticula in women: a single-centre experience. Eur Urol. 2014;66:164–72.CrossRef
5.
Zurück zum Zitat Stav K, Dwyer PL, Rosamilia A, et al. Urinary symptoms before and after female urethral diverticulectomy—can we predict de novo stress urinary incontinence? J Urol. 2008;180:2088–90.CrossRef Stav K, Dwyer PL, Rosamilia A, et al. Urinary symptoms before and after female urethral diverticulectomy—can we predict de novo stress urinary incontinence? J Urol. 2008;180:2088–90.CrossRef
6.
Zurück zum Zitat Baradaran N, Chiles L, Freilich DA, Rames RA, Cox L, Rovner RS. Female urethral diverticula in the contemporary era: is the classic triad of the “3Ds” still relevant? Urology. 2016;94:53–6.CrossRef Baradaran N, Chiles L, Freilich DA, Rames RA, Cox L, Rovner RS. Female urethral diverticula in the contemporary era: is the classic triad of the “3Ds” still relevant? Urology. 2016;94:53–6.CrossRef
7.
Zurück zum Zitat Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P. Recurrent urinary tract infections in women. Int Urogynecol J. 2015;26(6):795–804.CrossRef Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P. Recurrent urinary tract infections in women. Int Urogynecol J. 2015;26(6):795–804.CrossRef
8.
Zurück zum Zitat Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21:167–78.CrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21:167–78.CrossRef
9.
Zurück zum Zitat Ockrim JL, Allen DJ, Shah PJ, Greenwell TJ. A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes. BJU Int. 2009;103(11):1550–4.CrossRef Ockrim JL, Allen DJ, Shah PJ, Greenwell TJ. A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes. BJU Int. 2009;103(11):1550–4.CrossRef
10.
Zurück zum Zitat El-Nashar SA, Singh R, Bacon MM, Kim-Fine S, Occhino JA, Gebhart JB, et al. Female urethral diverticulum: presentation, diagnosis, and predictors of outcomes after surgery. Female Pelvic Med Reconstr Surg. 2016;22(6):447–452.9.CrossRef El-Nashar SA, Singh R, Bacon MM, Kim-Fine S, Occhino JA, Gebhart JB, et al. Female urethral diverticulum: presentation, diagnosis, and predictors of outcomes after surgery. Female Pelvic Med Reconstr Surg. 2016;22(6):447–452.9.CrossRef
11.
Zurück zum Zitat Santoro GA, Wieczorek AP, Dietz HP, Mellgren A, Sultan AH, Shobeiri SA, et al. State of the art: an integrated approach to pelvic floor ultrasonography. Ultrasound Obstet Gynecol. 2011;37(4):381–96.CrossRef Santoro GA, Wieczorek AP, Dietz HP, Mellgren A, Sultan AH, Shobeiri SA, et al. State of the art: an integrated approach to pelvic floor ultrasonography. Ultrasound Obstet Gynecol. 2011;37(4):381–96.CrossRef
12.
Zurück zum Zitat Wieczorek AP, Stankiewicz A, Santoro GA, Woźniak MM, Bogusiewicz M, Rechberger T. Pelvic floor disorders: role of new ultrasonographic techniques. World J Urol. 2011;29(5):615–23.CrossRef Wieczorek AP, Stankiewicz A, Santoro GA, Woźniak MM, Bogusiewicz M, Rechberger T. Pelvic floor disorders: role of new ultrasonographic techniques. World J Urol. 2011;29(5):615–23.CrossRef
13.
Zurück zum Zitat Patel AK, Chapple CR. Female urethral diverticula. Curr Opin Urol. 2006;16:248–54.CrossRef Patel AK, Chapple CR. Female urethral diverticula. Curr Opin Urol. 2006;16:248–54.CrossRef
Metadaten
Titel
Correlation between symptoms and imaging findings including pelvic floor ultrasound to improve the symptom-based diagnosis of female urethral diverticulum (CHECK-UD study)
verfasst von
Bara Barakat
Knut Franke
Sameh Hijazi
Ingmar Wolff
Boris Hadaschik
Christian Rehme
Publikationsdatum
19.04.2021
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 8/2022
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-021-04770-6

Weitere Artikel der Ausgabe 8/2022

International Urogynecology Journal 8/2022 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.