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Contemporary Characterization of Urethral Diverticulum

  • Reconstructed Bladder Function & Dysfunction (M Kaufman, Section Editor)
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Abstract

Purpose of review

This review summarizes the urethral diverticulum (UD) literature published since 2015 and evaluates the extent to which new contributions have changed our understanding of UD. Important components within the UD literature include its etiology, diagnosis, and surgical approach. We also examine what new evidence shows regarding UD surgical outcome data, particularly in comparing staged versus concomitant stress urinary incontinence (SUI) repair.

Recent findings

Important themes emerge from our review of the contemporary UD literature. The presentation of UD may remain elusive, with diagnosis hinging on careful history, physical exam, and imaging studies. While magnetic resonance imaging (MRI) remains the gold standard imaging modality of choice, there is increasing evidence to support the utility of ultrasound as a more cost-effective means of diagnosis. Transvaginal surgical excision and repair remains highly effective, although success decreases as complexity of the UD increases. Concomitant incontinence treatment remains the most controversial subject. Recent evidence lends support to a staged approach, making it appear less certain that a potential improvement in the rate of incontinence following UD repair is worth the downside of potentially overtreating SUI or failing to prevent de novo SUI.

Summary

The recent UD literature provides a host of new case series that allow for more informed clinical decision-making in diagnosis and treatment. Ultrasound imaging offers a promising alternative to MRI in resource-conscious settings. Recent evidence trends in favor of staged incontinence repair instead of concomitant incontinence repair, muddling the framework for standard of care and underscoring the importance of informed consent in educating UD patients.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Mayo Clinic Alix School of Medicine, Scottsdale, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA

    David Mauler

  2. Department of Urology, Mayo Clinic, Phoenix, AZ, USA

    Aqsa Khan & Christopher Wolter

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  1. David Mauler
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  2. Aqsa Khan
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  3. Christopher Wolter
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Correspondence to Christopher Wolter.

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Conflict of Interest

Christopher E Wolter serves on the Clinical events Committee for IMARC Research Inc. Aqsa A Khan and David J Mauler declare that they have no conflicts of interest.

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Mauler, D., Khan, A. & Wolter, C. Contemporary Characterization of Urethral Diverticulum. Curr Bladder Dysfunct Rep 17, 48–53 (2022). https://doi.org/10.1007/s11884-021-00639-y

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