Counseling and Monitoring
Surgery is the main way to treat UD. Still, not all cases call for surgery. Some patients may not want it, or be able to have surgery.
Not much is known about untreated UD. It is not known if the pockets will become larger or if symptoms will get worse. Some people prefer to wait until symptoms get worse before doing anything. In rare cases there have been reports of cancers growing in people with UD.
If you prefer not to have surgery, counseling and follow-up visits with your doctor is important.
Surgical excision is the treatment of choice. It should be performed with care with an experienced urologist. The UD sac may be attached to the urethral opening. If the sac is not removed carefully, it could damage the urethra. This would lead to a major surgical repair.
Surgical options are:
- Cutting into the sac neck
- Creating a permanent opening of the sac into the vagina
- Removing the sac
Other Key Issues in Surgery
- The diverticular neck (the connection to the urethral opening) should be closed.
- The lining of the diverticular sac should be fully removed to prevent the UD from coming back.
- A closure with many layers is needed so a new opening doesn’t form between the urethra and vagina.
- If you have stress urinary incontinence (SUI), a procedure to fix the leaking may be done at the same time as fixing the diverticulum.