Comparison of Supine and Prone Positioning in Female Patients Undergoing Urethral Diverticulum Excision
Journal Title: Journal of Urological Surgery - Year 2021, Vol 8, Issue 1
Abstract
Objective: Transvaginal excision of urethral diverticulum (UD) is the gold standard treatment for symptomatic women with UD. Complete UD excision can be challenging due to poor access to the surgical field, especially with proximal, circumferential and recurrent UD. Prone patient positioning has been suggested as an effective way of improving surgical access and vision compared to the traditional supine positioning. However, direct comparison of the two positions is yet to be performed. This study aimed to compare patients who underwent UD excision in prone and supine positions. Materials and Methods: Prospectively recorded data of 79 women undergoing urethral diverticulectomy between 2004 and 2017 in a single referral centre were reviewed. Patients were operated either in supine or prone positions based on the surgeon’s preference. Data collected included patient demographics, UD characteristics on magnetic resonance imaging, intraoperative details and postoperative outcomes. Operative time was calculated from the electronic theatre records starting from the entry of the patient into the operating room to their exit. Results: The mean patient age was 42.38 (±15.24) years. More than half of the patients had a recurrent UD at presentation (51.89%). The mean size of the diverticulum was 25.06 (±1.2) mm, and the mean operative time was 146.18 (±6.0) min. UD excision was undertaken in prone position in 50 (63.3%) and supine position in 29 (36.7%) patients. Patients in the prone position group were older and had relatively larger and proximal UD. In the multivariable analysis, it was found that a proximally located UD was the main indicator for undergoing surgery in the prone position. Conclusion: Despite longer operative times, prone patient positioning appears to be the preferred option for patients with larger and proximal UD, presumably because it offers better access to the surgical field.
Authors and Affiliations
Naşide Mangır, Richard Inman, Christopher Chapple
Keywords
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- EP ID EP693415
- DOI 10.4274/jus.galenos.2021.0026
- Views 117
- Downloads 0
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