[Diverticula of the female urinary tract--still a problem in urogynecology]

An importance of knowledge of etiology, pathogenesis, diagnosis, differential diagnosis and treatment of female urethral diverticulum in urogynaecological practise.

A review article.

Obstetrics and Gynaecology Department and Urology Department, Charles University 2nd Medical School and Teaching Hospital Motol, Prague.

Often unrecognized or incorrectly diagnosed, urethral diverticulum may be completely asymptomatic or may produce significant symptomathology, such as recurrent urinary tract infections and irritative or obstructive complaints. A full history and careful physical examination are the first steps in screening. Diagnosis is usually made by voiding cystourethrography, positive pressure urethrography, urethroscopy or introital ultrasonography. Complete excision through the anterior vaginal wall is the most successful treatment modality with minimum postoperative complications. Concomitant bladder neck suspension can be performed in women with diverticulum and documented stress urinary incontinence.

Urethral diverticula may mimic other pelvic floor disorders and result in diagnostic delay. It is partly due to a lack of awareness among clinicians and partly because the condition overlaps the traditional territories of gynaecologists and urologists. The collaboration of both specialists in the diagnostics and treatment of female urethral diverticula is recommended.