Abstract
Purpose
We present the management of 17 cases of urethral diverticulum in our department. We describe the various clinical presentations of urethral diverticulum, which may mimic other pelvic floor disorders and result in diagnostic delay.
Materials and Methods
We reviewed 17 cases of urethral diverticulum presented to the urogynaecology department between January 2006 and February 2011 retrospectively. Patient demographics, history, clinical evaluation, diagnostic modalities, and management plans were reviewed. All of them underwent Magnetic Resonance Imaging (MRI) prior to the procedure.
Results
The mean time from onset of symptoms to diagnosis of a urethral diverticulum was 24 ± 5.6 months. MRI identified the urethral diverticulum in all cases while voiding cystourethrography confirmed the diagnosis in 4 (23.5 %). They have been divided into two groups: Group A, (4–6 mm largest axis range) 5 (29.41 %) cases; Group B, (6–33 mm largest axis range) 12(70.59 %). All in Group A were symptomatic with recurrent Urinary Tract Infection (UTI), whereas only 8 (66.6 %) in Group B were symptomatic. Transvaginal diverticulectomy was done in 12 women who were symptomatic (70.5 %). Postoperative evaluation revealed complete resolution of symptoms, such as recurrent UTI, dysuria, and dyspareunia. One patient was unsure of surgery, while conservative approach was opted for asymptomatic patients 4 (23.5 %). The use of preoperative MRI altered the management in 2 (11.7 %) women.
Conclusion
The diagnosis of urethral diverticulum should be considered in women with recurrent UTI, dysuria, dyspareunia, and irritative voiding symptoms not responding to conservative therapy.
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Abbreviations
- MRI:
-
Magnetic Resonance Imaging
- UTI:
-
Urinary Tract Infection
- UD:
-
Urethral Diverticulum
- VCUG:
-
Voiding Cystourethrogram
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Compliance with ethical requirements and Conflict of interest
Informed consent was obtained from all patients for being included in the study. As this project was registered with the clinical effectiveness department, ethical approval was not required. The authors declare that they have no conflict of interest.
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Arunkalaivanan, A.S., Baptiste, M. & Sami, T. Urethral Diverticulum in Women: Retrospective Case Series. J Obstet Gynecol India 66, 47–51 (2016). https://doi.org/10.1007/s13224-014-0642-0
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DOI: https://doi.org/10.1007/s13224-014-0642-0