Analysis Of The Diagnosis And Treatment Of Female Urethral Diverticulum

Objective:Historical and current diagnosis and treatment of female urethral diverticulum(FUD)were analyzed systematically.Combined with clinical cases in our hospital,we used qualitative and quantitative methods to research the diagnosis and treatment criteria of female urethral diverticulum.Clinical basis were provided to improve clinical attention and reduce the misdiagnosis rate of the disease.And existing surgical procedures were explored in a new way.Method:In this study,we searched the relevant literatures in the four major databases of China and the foreign database Pub Med.“specific clinical symptoms description of female urethral diverticulum in the literature” is the inclusion criteria and“no female urethral diverticulum cases in the literature or no patient specific clinical symptoms" is the standard of exclusion,then combined with the clinical cases in our hospital.We analyzed it with qualitative and quantitative methods in four parts of the data : 1,The analysis of diagnosis and treatment of domestic FUD;2,The analysis of diagnosis and treatment of foreign FUD;3,the analysis of diagnosis and treatment of FUD in ourhospital;4,All the data were statistically analyzed.The clinical information,attention,clinical symptoms,diagnosis and treatment status and prognosis of female urethral diverticulum were comprehensively evaluated.Result:?.Statistical analysis of domestic literature data: From the first publication to December 31,2018,there are 46 female urethral diverticulum papers in 53 years.The total number of patient which was diagnosed as female urethral diverticulum is 387.All the articles were descriptive papers.There was no large randomized controlled study.The evidence-based medical evidence evaluation level was not high.We use bibliometric methods to analyze Article publications region and classification : the clinician's attention to FUD is insufficient.The appearance of various symptoms frequency analysis showed that : urinary tract irritation with dysuria are commen.When touching the lump on the anterior wall of the vagina and the squeezing sign is positive,the FUD should be highly suspected.Combined with imaging examination,diagnosis can be made.Operation is the best treatment.?.Statistical analysis of all literatures on FUD in foreign countries in the past 10 years : A total of 37 related papers have 375 valid cases.There are no randomized controlled research reports.According to the publishing area,the level around the world of diagnosis and treatment ofFUD is different;The appearance of various symptoms frequency analysis showed that : The FUD patients in foreign countries mainly have repeated urinary tract infections,accompanied by dysuria and most of them have urinary incontinence at the same time.Most patients can touch the lump on the anterior wall of the vagina.But there is less description of the squeezing sign.The operation is the preferred treatment method.The surgical method is diverse and there is no comparison of the surgical effects.?.There were 10 cases of FUD in our hospital.Four cases were diagnosed as paraurethral cysts and two patients were diagnosed correct in our hospital after missed diagnosis.Many patients had urethral irritation.Nine patients were underwent surgery.There was no recurrence at present.And one patient had no significant improvement in symptoms after conservative treatment.?.A total of 772 cases were recorded in the three sections.Statistical analysis was performed on the symptoms,signs and treatment methods of 772 patients.There were statistically significant differences in the two signs of the patients in China and abroad(P<0.05).There was no significant difference in the physical signs between the domestic and the patients in our hospital(P>0.05).There was no significant difference in the symptoms of dysuria between the domestic and foreign patients(P>0.05).There are statistical differences in other symptoms.There wasstatistically significant difference in the squeezing sign and dysuria between the urethral diverticulum and the paraurethral cyst(P<0.05).There was statistically significant difference between the surgical treatment and conservative treatment(P<0.05).There was statistically significant difference between preoperative and postoperative symptoms of the patients in our hospital(P < 0.05).Conclusion:Firstly,female urethral diverticulum should be a morphological diagnosis that has not been determined at present.It is recommended to adopt "female urethral diverticulosis change" as the preliminary diagnosis since the histopathological report has not been confirmed yet.Second,the diagnostic points of female urethral diverticulosis include: the clinical manifestations of repeated urinary tract irritation and dysuria,the palpable masses in the anterior vaginal wall and positive squeezing sign.And the patients who are highly suspected of "female urethral diverticulosis change" should be further evaluated by imaging examinations such as urethroscopy and urethrography.Third,the accurate diagnosis of female urethral diverticular degeneration depends on the histopathological basis and is determined by the muscular layer and epithelial cells of the diverticular wall tissue.Fourth,the treatment of female urethral diverticulosis was basically consistent.The diverticular tissue was excised to restore the integrity of the urethra.