Contemporary evaluation and management of the female urethral diverticulum

Aspera, A. Michele; Rackley, Raymond R.; Vasavada, Sandip P.

doi:10.1016/s0094-0143(02)00058-7

Cited by 59 publications

(39 citation statements)

References 20 publications

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“…One patient with a huge diverticulum, which had a fistula opening into the vagina, presented with day-and night-time incontinence. Some patients even did vaginal surgery [3] . Congenital formation of urethral diverticulum has also been suggested, particularly in pediatric patients [4] .…”

Section: Introductionmentioning

confidence: 99%

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Chang

Lin

Chen³

2008

Urol Int

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Introduction: Symptoms or signs of female urethral diverticulum are usually not typical, thereby resulting in delayed or wrong diagnosis. This paper relates to our experience on the diversity of presenting symptoms and signs of female urethral diverticula. Materials and Methods: We reviewed the medical records and conducted telephone interviews of 14 patients with the diagnosis of female urethral diverticulum in our institution. Results: The mean patient age at diagnosis was 47.5 years (range 22–65 years) and the mean duration between symptom presentation and diagnosis was 6.46 years (range 1 month to 30 years). Their presenting symptoms were so diverse that many were initially treated under the diagnosis other than urethral diverticulum. Most patients were treated as uncomplicated urinary tract infection for a long time. Stress urinary incontinence (SUI) was so dominant in 2 patients with big diverticula that they were falsely treated with anti-incontinence surgery. Total incontinence happened in 1 patient with genuine SUI and a big urethral diverticulum. One patient with a huge diverticulum, which had a fistula opening into the vagina, presented with day- and night-time incontinence. Some patients even did not have incontinence, but only had dysuria or a painful anterior vaginal wall nodule. Nevertheless, detailed analysis on symptoms and signs usually may suggest urethral diverticulum. We found that recurrent urinary tract infection, urinary incontinence, palpable suburethral mass, vaginal tenderness, and dysuria are the five major presenting symptoms and signs. The diagnostic rate of voiding cystourethrography during video-urodynamics, double-balloon urethrography and MRI were 10/10 (100%), 6/6 (100%) and 10/11 (90.9%) respectively. Conclusions: The presenting symptoms and signs of female urethral diverticula are often diverse and easily overlooked. High suspicion of this disorder, detailed history-taking and physical examination are essential for detecting urethral diverticulum in females.

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Section: Introductionmentioning

confidence: 99%

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Chang

Lin

Chen³

2008

Urol Int

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“…8 Urethral diverticula, although comparatively rare, are frequently under diagnosed due to a lack of clinical awareness. Often, the condition is been diagnosed as interstitial cystitis, chronic pelvic pain and urethral syndrome among others.…”

Section: Discussionmentioning

confidence: 99%

A rare case of giant primary calculus in female urethral diverticulum

Verma¹,

Ahmad²,

Rai³

2016

Int Surg J

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“…According to Aspera et al [3] , the most common symptoms suggestive of a urethral diverticulum in a woman are, in decreasing order of mean frequency: recurrent urinary tract infections (38%), urinary incontinence (37%), dysuria (30%), urgency (28%), frequency (27%), pain (urethral/postvoid; 23%), postvoid dribbling (17%), dyspareunia (15%), a vaginal mass (13%), hematuria (11%), and urinary retention (8%). Since some of these symptoms are quite common, the possibility of a urethral diverticulum is not usually included in the evaluation of women with pelvic disorders.…”

Section: Discussionmentioning

confidence: 99%

Urethral Diverticulum: A New Complication Associated with Tension-Free Vaginal Tape

Athanasopoulos

McGuire²

2008

Urol Int

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A case of a urethral diverticulum following the insertion of a tension-free vaginal tape (TVT) is presented. The patient was a woman with stress urinary incontinence who underwent surgery to correct intrinsic sphincter deficiency. Three cases of urethral diverticula have been published thus far as complications of TVT insertions, but this is the first complication associated with intrinsic sphincter deficiency. The high pressures in the proximal urethra that result from positioning the TVT in the middle urethra, especially when obstruction co-exists with an open bladder neck, can be a predisposing factor for this complication. The possibility of a urethral diverticulum when postvoid incontinence occurs after the insertion of a TVT should be carefully evaluated.

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Contemporary evaluation and management of the female urethral diverticulum

Cited by 59 publications

References 20 publications

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Presentation of Female Urethral Diverticulum Is Usually Not Typical

A rare case of giant primary calculus in female urethral diverticulum

Urethral Diverticulum: A New Complication Associated with Tension-Free Vaginal Tape

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