Excision of Urethral Diverticula

  • Shlomo Raz


Urethral diverticula result in most cases from inflammatory conditions of the periurethral glands. Most are the result of repeated infection and obstruction of the periurethral glands. Initially, a suburethral cyst is formed by both the inflammatory process of infection and by the pressures created within an obstructed periurethral gland. These cysts subsequently rupture into the urethral lumen. The resulting draining abscess cavity is eventually epithelialized, and thus a urethral diverticulum is formed. Very rarely, they are congenital or traumatic following urethroscopy or urethrotomy. Open surgical procedures such as anterior colporrhaphy or bladder neck suspension surgery may damage the periurethral fascia and create a traction diverticulum.


Urethral diverticula Diagnosis Excision of urethral diverticula 

Supplementary material

Video 4.1

Excision of urethral diverticula. An inverted U incision is made in the anterior vaginal wall. A flap is dissected free from the periurethral fascia with care not to enter the diverticula. A transverse incision is made on the periurethral fascia, and two flaps (one superior and one inferior) are created to expose the wall of the diverticula and sphincteric unit. The wall of the diverticula is carefully excised from the urethra. The communication of the diverticula to the urethra is closed in multiple layers. Interrupted figure-of-eight absorbable sutures are applied posterior to the urethra and to the endopelvic fascia to seal the periurethral space and prevent any dead space. The periurethral fascia is closed in transverse fashion with multiple figure-of-eight sutures. The vaginal wall flap is advanced distally to cover the area of the reconstruction. (MP4 251875 kb)

Suggested Reading

  1. Davis HJ, TeLinde RW. Urethral diverticula: an assay of 121 cases. J Urol. 1958;80:34–9.PubMedGoogle Scholar
  2. Eilber KS, Raz S. Benign cystic lesions of the vagina: a literature review. J Urol. 2003;170(3):717–22.CrossRefPubMedGoogle Scholar
  3. Ganabathi K, Leach GE, Zimmern PE, Dmochowski R. Experience with the management of urethral diverticulum in 63 women. J Urol. 1994;152(5 Pt 1):1445–52.PubMedGoogle Scholar
  4. Lee RA. Diverticulum of the urethra: clinical presentation, diagnosis, and management. Clin Obstet Gynecol. 1984;27(2):490–8.CrossRefPubMedGoogle Scholar
  5. Nickles SW, Ikwuezunma G, MacLachlan L, El-Zawahry A, Rames R, Rovner E. Simple vs complex urethral diverticulum: presentation and outcomes. Urology. 2014;84(6):1516–20.CrossRefPubMedGoogle Scholar
  6. Reeves FA, Inman RD, Chapple CR. Management of symptomatic urethral diverticula in women: a single-centre experience. Eur Urol. 2014;66:164–72.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Shlomo Raz
    • 1
  1. 1.Division of Pelvic Medicine and Reconstructive SurgeryUCLA School of MedicineLos AngelesUSA

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