“Flap Technique” in Female Urethral Diverticulectomy: Optimizing Outcomes and Preventing Recurrence
Introduction Female urethral diverticulum is rare, often elusive in diagnosis, and classically associated with dysuria, dyspareunia, and post void dribbling. Surgical excision remains the gold standard, but recurrence, fistula, and stress incontinence are persistent challenges.

Study Design & Materials 
This is retrospective cohort study. Patients with suspected malignancy were excluded. Preoperative workup included clinical evaluation, cystourethroscopy, and selective urodynamic assessment. All repairs were performed with multilayer watertight closure.
Methods Five women (mean age 36 years) with symptomatic diverticulum (mean size 2.8 cm) underwent transvaginal diverticulectomy at a tertiary centre. Diagnosis was confirmed by MRI. Anterior vaginal wall flap is raised for diverticulectomy.

Results
•	Mean operative time: 95 minutes
•	Symptom resolution: 80% (4/5 patients)
•	No recurrence or fistula at 6 month follow up
•	One case of mild stress urinary incontinence, managed conservatively
•	No flap related complications

Interpretation : Transvaginal Flap  reinforces urethral closure, reduces tension, and obliterates dead space, Close the incision in a multi-layered fashion with no overlapping suture lines; 
—critical factors in preventing recurrence and fistula. Functional outcomes were satisfactory, though continence requires ongoing surveillance.

Conclusion transvaginal Flap based urethral diverticulectomy is a safe, effective technique with low complication and recurrence rates. Vascularized flap interposition should be considered, particularly in complex cases, to optimize long term outcomes and patient quality of life.

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