Magnetic resonance imaging of female prostate pathology

The female prostate (paraurethral glands) is a well-known, yet poorly understood, anatomic structure. Imaging studies of the female prostate, its physiology, and pathologies are still highly controversial.

To study the anatomy of the female prostate with contemporary magnetic resonance imaging (MRI) techniques and correlate these findings to clinical features.

Female prostate pathologic anatomy on MRI.

Women with clinical signs of function (or dysfunction) of paraurethral glands have been examined with 1.5 or 3 Tesla MRI and urethroscopy.

Seven women aged 17 to 62 years (median 40 years) have been prospectively included into the study. Clinically, one of the seven women reported ejaculation at orgasm, whereas three women presented with occasional secretions independent of sexual stimulation. In two women, paraurethral glands have been randomly found on MRI that has been performed in the diagnostic workup of other diseases. One woman presented with swelling of the external urethral meatus at puberty. In this woman, a paraurethral gland has been found, besides the erectile tissue at the external meatus. Two women reported lower urinary tract symptoms (LUTS) with mainly urethral symptoms (recurrent infections in one and paraurethral stones in the other). On MRI, paraurethral glands could be visualized in six of the seven patients. There was no relation between glandular volume and ejaculation status. In cases where glands or related pathologies could be found on physical examination, there was a clear correlation with MRI anatomy.

MRI has the potential to become the standard imaging modality for female prostate pathology. Exact visualization of this highly variable structure is possible by tailored MRI protocols. This tool can aid in understanding an individual woman's symptoms related to paraurethral glands with an impact on her sexual life.