Female prostatic occlusive syndrome: A case report of MRI analysis and literature review

Female prostatic occlusive syndrome (FPOS) is a rare condition caused by obstruction of the female urethra due to hypertrophic or cystic Skene's glands-the embryologic homologues of the male prostate. Because its clinical manifestations are nonspecific, FPOS is frequently misdiagnosed as urethral diverticulum, cystitis, or other lower urinary tract disorders, often leading to delayed or inappropriate treatment. This study aimed to characterize the MRI features of FPOS and to discuss the diagnostic challenges associated with this entity. We report the case of an 87-year-old woman who presented with straining during urination and intermittent urinary stream. Pelvic MRI demonstrated urethral lumen narrowing and a 1.4 cm periurethral lesion with a T2-hyperintense core and a hypointense rim. The lesion exhibited restricted diffusion, with an apparent diffusion coefficient (ADC) value of 1.1 × 10^-³ mm²/s, and no urinary tract calculi or other abnormalities were observed. This case illustrates that FPOS exhibits distinctive multiparametric MRI findings, which can aid in differentiating it from other periurethral lesions, thereby improving diagnostic accuracy and avoiding delays in diagnosis.