Long term follow-up study of the marsupialization technique for urethral diverticula in women.

Fifty-seven women with urethral diverticula were evaluated between 1977 and 1986. Thirty-seven patients had a history of documented recurrent urinary tract infections. Other common leading symptoms were dysuria, frequency, stress urinary incontinence and dyspareunia. The diagnosis was established in 26 patients by voiding cystourethrography. A Spence marsupialization procedure was performed upon 40 patients. Postoperatively, all patients had normal voiding cystourethrograms, sterile urine and relief of symptoms. On long term follow-up study (mean of five years), 53 patients considered the operation as having been successful. Complications were encountered in four patients--stress urinary incontinence grade I in three patients and recurrent urinary tract infection in association with urethral stricture in one patient. The Spence marsupialization procedure is associated with a high success rate and low morbidity, thus, making it applicable to the majority of all distal urethral diverticula in women.