Complete husking
The cyst is adjacent to the urethra, and the main principle is to remove it en bloc with the capsule, without opening: the left fragment of the lining causes relapse, and rough work leads to the risk of fistula. The passages to the urethra are sutured using a catheter; the bed is sutured with restoration of the vaginal wall. Punctures and “openings” of cysts provide only a temporary effect - in case of recurrent suppuration, radical excision is planned without an exacerbation. Sexual rest 3–4 weeks; follow-up examination confirms healing; urination is not affected.
Indications
- polyp of the external urethral opening in women: bleeding, pain, dysuria;
- urethral caruncle, mucosal prolapse;
- paraurethral cyst (tabernacle glands): formation near the urethra, dyspareunia, suppuration;
- recurrent urethritis associated with a cyst.
Features of urethral surgery
The urethral area requires jewelry technology: it is important to radically remove the formation and at the same time maintain lumen and urine retention. Polyps are excised at the base and plastic surgery of the mucosa “edge to edge” - relapses are rare; paraurethral cysts are necessarily enucleated entirely (opening leads to relapse and fistulas), and the passage into the urethra, if present, is sutured with a catheter. Histology excludes rare urethral tumors. The operations are performed by urologists with experience in reconstruction; urination function is completely preserved.
