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Why is it done?

  • Usually, an infected peri-urethral gland blocks and becomes infected
  • Causes a bulge which interferes with urination
  • Can mimic prostate enlargement LUTS
  • Usually an MRI of the urethra delineates this beautifully.

 

How is it done?

  • This procedure is done under a general anaesthetic, as decided by the anaesthetist.
  • The legs will be elevated into the lithotomy position.
  • This procedure is done both cystoscopically and with an incision over the urethra (Bulbous Spongiosum or Perineum)
  • The urethra is evaluated. endoscopically and a catheter placed
  • If it is a small urethral diverticulum it can be opened into the urethra endoscopically
  • If it has a narrow neck then an external approach:
  • The Penis or Perineum will then be incised over the urethrocoele.
  • A Fogarty catheter will be placed inside the diverticulum and the balloon inflated to delineate the borders of the diverticulum.
  • The diverticulum will be dissected out with injuring adjacent structures.
  • The neck will be tied off at the level of the adjoining urethra.
  • Dissolvable closure sutures will be placed for hemostasis
  • A cystoscopy confirms no injury to the urethra.
  • A catheter will be placed until you are awake for some compression.
  • Prophylactic antibiotics will be given to prevent infection.

Complications

Side–effects

  • Any anaesthetic has its risks and the anaesthetist will explain all such risks.
  • Complications: hemorrhaging, and urine retention
  • Patients catheter will be removed the next morning
  • If you cannot urinate after 2-3 attempts, a catheter may be inserted to empty your bladder.
  • You may suffer temporary incontinence
  • You may suffer permanent incontinence as advised by Jo, depending on the extent of the diverticulum. Make sure you have discussed this with Jo.
  • NB! Each person is unique and for this reason, symptoms may vary!

 

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Copyright 2019 Dr Jo Schoeman