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Related Concept Videos

Ureters01:22

Ureters

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The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Related Experiment Video

Updated: Dec 21, 2025

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Clear cell carcinoma in a urethral diverticulum.

Emer Hatem1, Arun Sahai1, Sachin Malde1

  • 1Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Urology Case Reports
|May 22, 2020
PubMed
Summary

A rare clear cell carcinoma complicated a complex urethral diverticulum in a woman with recurrent urinary tract infections. Surgical management involved radical resection and urinary diversion due to positive tumor margins.

Keywords:
CancerCarcinomaInfectionMalignancyUrethral diverticulumUrethrectomy

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Area of Science:

  • Uro-oncology
  • Surgical pathology
  • Medical imaging

Background:

  • Recurrent urinary tract infections (UTIs) and voiding dysfunction can indicate underlying complex urological pathology.
  • Urethral diverticula, though uncommon, can present with diverse symptoms including infection, stones, and fistulation.

Observation:

  • A 54-year-old female presented with chronic UTIs, urgency, frequency, hematuria, stress incontinence, and voiding difficulty.
  • Physical examination revealed a significant anterior vaginal wall mass with purulent discharge.
  • MRI demonstrated a complex urethral diverticulum containing calculi and a vaginal fistula.

Findings:

  • Abscess drainage and biopsy of the urethral diverticulum confirmed clear cell carcinoma.
  • The patient underwent urethrectomy, bladder neck closure, and Yang-Monti urinary diversion.
  • Positive tumor margins necessitated subsequent cystectomy and ileal conduit formation.

Implications:

  • This case highlights the importance of thorough investigation for complex urethral diverticula, even in the context of chronic UTIs.
  • Clear cell carcinoma arising in a urethral diverticulum is exceedingly rare and presents significant surgical challenges.
  • Aggressive surgical management, including radical resection and urinary diversion, may be required for optimal oncological outcomes.