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An update on urethral diverticula: Results from a large case series
Athina Pirpiris1, Garson Chan2,3, Richard C Chaulk3
1Monash Health, Clayton, Victoria, Australia.
Summary
Urethral diverticula in women often present as a vaginal lump, lower urinary tract symptoms, or recurrent UTIs. Pelvic MRI is crucial for diagnosis and surgical planning.
Area of Science:
- Urology
- Diagnostic Imaging
Background:
- Urethral diverticula are rare but can cause significant symptoms.
- Accurate diagnosis and surgical planning are essential for effective management.
Purpose of the Study:
- To describe the presentation, investigations, and management of female urethral diverticula.
- To evaluate the role of magnetic resonance imaging (MRI) in diagnosis and surgical planning.
Main Methods:
- Retrospective review of 17 female patients undergoing urethral diverticulectomy.
- Data collected on demographics, symptoms, investigations, surgical technique, and follow-up.
- Preoperative pelvic MRI was analyzed for diverticula characteristics and communication with the urethra.
Main Results:
- Most common presentations included palpable vaginal lump (70%), lower urinary tract symptoms (LUTS) or recurrent urinary tract infections (UTIs) (64%).
- Preoperative MRI accurately identified diverticula location and morphology, correlating with operative findings.
- MRI demonstrated urethral communication in 80% of cases, significantly higher than endoscopy (47%).
Conclusions:
- Urethral diverticula commonly present with a vaginal lump, LUTS, or recurrent UTIs, requiring a high index of suspicion.
- Pelvic MRI is an ideal imaging modality for diagnosing urethral diverticula.
- Preoperative MRI aids in excluding other pathologies, patient counseling, and surgical planning.
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