Periurethral and Anterior Vaginal Wall Masses: Etiology, Presentation, and Treatment Outcomes
Notice bibliographique
Résumé
ABSTRACT Periurethral and anterior vaginal masses are relatively common with an estimated prevalence of 3% to 4% and 1%, respectively. These masses often cause diagnostic challenges due to nonspecific and overlapping symptoms. Urinary symptoms include frequency, urgency, and dysuria; vaginal discharge, urinary tract infection (UTI), dyspareunia, bleeding, postvoid dribbling, pelvic and urethral pain, and palpable mass can also present. Familiarity with differentiation of masses is important to make timely diagnoses and to expedite treatment without delays. This study aimed to describe the etiology of periurethral and anterior vaginal wall masses in a large series, as well as report the clinical presentations to determine whether the differential diagnosis can be narrowed based on presenting symptoms. The study consisted of a retrospective chart review, based on charts of patients from November 2001 to July 2021 at a tertiary referral center. Analyzed data included age, body mass index, operative findings, operative time, concomitant procedures, pathologic diagnosis, catheterization time, complications, length of stay, symptoms on follow-up, and follow-up duration. Describing the etiology of periurethral and anterior vaginal wall masses was the primary objective of the study (including underlying etiology distribution), followed by the secondary objective of describing rates of other clinical characteristics. A systematic search of literature was performed using various databases: MEDLINE (Ovid), Cochran Central Register of Controlled Trials (Wiley Online Library), EMBASE (Elsevier), and Scopus. The study included a total of 126 patients, all with at least 1 symptom exhibited. The most common presenting symptoms were palpable mass, dyspareunia, and urinary tract symptoms (dysuria, stress urinary incontinence [SUI], and UTI). There was an infection rate of 21.4% and a malignancy rate of 1.6%. Each patient underwent surgical treatment, including urethral repair, periurethral cyst excision, urethral diverticulectomy, and lesion excision. A total of 29.4% of patients reported SUI preoperatively. Postoperatively, 105 patients reported no incontinence (83.3%), 15 reported SUI (11.9%), 5 reported mixed urinary incontinence (4%), and 1 presented with overflow incontinence (0.8%). Limitations of the study include the prospective collection of data but its retrospective analysis, thereby limiting findings according to the accuracy and completeness of the medical records. In addition, there was an absence of patient-reported outcome measures when SUI or other symptoms were assessed, and the authors recognize a need for future prospective studies to include such outcome measures. This large series evaluation of periurethral and anterior vaginal wall masses is the largest of its kind, as the previous study included only 79 patients with periurethral masses, 96% of whom had definitive pathological diagnoses and surgical treatment. This study provides a broad view into the etiological spectrum underlying periurethral and anterior vaginal masses. Malignancy is rare. Infectious pathology is common and found in 21.4% of patients, whereas urethral diverticulum was the most common pathology (40% of cases). Finally, this study indicated high success rates for surgical excisions, as there were no recurrences among diverticula patients in the study. For Skene’s gland cyst excisions, a recurrence rate of less than 1% was noted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».