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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!
Copyright 2019 Dr Jo Schoeman