Diverticular resection

(A) Incision and development of periurethral fascial planes. The incision in the fascia should be over the central diameter of the diverticular lesion.
(B) Dissection (circumferential) of the diverticular sac to the urethral ostium. The dissection plane between the sac and the urethra may be poorly defined in the presence of substantial peridiverticular inflammation.
(C) Running closure of the urethral defect over a small caliber (14 Fr) urethral catheter. Avoid excessive tension or compromise of the lumen.
(D) Vaginal closure after periurethral reapproximation.