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[Clinical aspects of urethral diverticula]
Insights
Urethral diverticula, though rare, can cause significant urinary symptoms and complications like infection or cancer. Early diagnosis via urography is crucial for effective treatment and to prevent recurrence.
Area of Science:
- Urology
- Surgical Pathology
Context:
- Urethral diverticula are rare congenital or acquired outpouchings of the urethra.
- This study reports on 39 cases treated between 1954 and 1974, highlighting clinical presentation and management.
Purpose:
- To review the clinical experience with urethral diverticula over a 20-year period.
- To identify common symptoms, complications, and treatment outcomes for urethral diverticula.
Summary:
- The study analyzed 39 patients (32 female, 7 male) with urethral diverticula, with most cases presenting between ages 31-60.
- Common symptoms included cystitis (two-thirds of patients), with lower incidence of dyspareunia and prostatitis.
- Complications observed were infection (80%), stones (3 cases), recurrence, and one case of planocellular carcinoma. Surgical intervention was performed in 35 patients, with 3 developing postoperative fistulas requiring reoperation.
Impact:
- Highlights the importance of considering urethral diverticula in patients with recurrent urinary tract infections, cystitis, or prostatitis.
- Recommends urography for diagnosing urethral diverticula when symptoms are persistent.
- Provides long-term clinical data on the surgical management and potential complications of urethral diverticula.
Abstract:
Experience with the treatment of 39 cases of urethral diverticula between the years 1954 and 1974 is reported. The patients were 32 women and 7 men. In 7 cases (3 women and 4 men) the condition was congenital in origin. In 30 patients the first symptoms appeared between the 31st and 60th year. In a 12 months old infant a hazelnut sized diverticulum in the posterior urethra caused complete ischuria. In two-third of the patients symptoms of cystitis dominated, dyspareunia in women (8%) and prostatitis in men (16%) had a lower incidence. 80% of the diverticula were infected; they contained stones in 3 cases. In one case the diverticulum recurred and histology revealed in its wall a planocellular carcinoma. Thirty-five patients were subjected to operation. Postoperative fistula developed in 3 cases which had to be re-operated. In cases of recurring urethritis, cystitis and prostatitis, urography is recommended, since the symptoms might be due to the presence of urethral diverticula.