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[Diagnosis of urethral diverticula and periurethral masses]
R Tunn1, U Bergmann-Hensel, D Beyersdorff
1Frauenklinik, Charité, Humboldt-Universität zu Berlin. rtunn@charite.de
Aim:
To give recommendations for the standard diagnostic assessment of urethral diverticula and periurethral masses based on an evaluation of our results and a survey of the recent literature.
Methods:
Group I (1981-1993) included 47 women in whom urethral diverticula (n = 34), periurethral cysts (n = 11), and periurethral leiomyomas (n = 2) were diagnosed and the results compared with the intraoperative findings. Diagnostic work-up comprised history taking, vaginal palpation, introitus ultrasound, double-balloon urethrography (DBU), voiding cystourethroscopy (VCU), excretion urography (EU), and urethrocystoscopy. Group II (1994-1996) included 12 women with urethral diverticula who were examined by DBU, 2D and 3D introitus ultrasound. The diagnostic accuracy of the different methods was assessed.
Results:
Group I: The diagnostic accuracy in identifying urethral diverticula was 85.3% for palpation, 61.5% for introitus ultrasound, 93.8% for DBU, 37.5% for EU, and 30.0% for urethrocystoscopy. Of all imaging modalities used, only introitus ultrasound depicted periurethral cysts and leiomyomas. Group II: The DBU, 2D and 3D introitus ultrasound had a diagnostic accuracy of 100% in identifying urethral diverticula.
Conclusions:
Introitus ultrasound should be used as the basic diagnostic tool in clinically suspected urethral diverticula or periurethral masses and additional DBU should be restricted to cases with inconclusive findings.