Female urethral diverticulum Clinical aspects and a presentation of 15 cases

Abstract

Diverticulum of the urethra is to be suspected in women with unexplained lower urinary tract symptoms. We recommend a collaboration of the two specialties: Gynaecology and Urology.

Le diverticule de l’urètre féminin: à propos de 18 cas

“…Ces glandes périurétrales se drainent pour plus de 90% d′entre elles au niveau du tiers moyen ou distal de l′urètre. Le diagnostic est évoqué sur la triade symptomatique des trois «D» selon les anglosaxons: dribbling, dyspareunia, dysuria [ 7 ]. L′issue de pus par le méat urétral au cours des manoe'uvres exprimant la poche tels les rapports sexuels et les toilettes vaginales, la miction en 2 temps par vidange de la poche sont très évocateurs du diagnostic.…”

“…Par ailleurs, l′examen clinique permet d′établir le diagnostic de DU dans plus de 60% 90% de cas [ 2 , 7 ] parfois cet examen est strictement normal. Typiquement la poche se présente sous forme d′une tuméfaction vaginale antérieure sensible.…”

Translabial sonography of vaginal fibroids: report of 2 cases and review of the literature.

“…11,12 The differential diagnosis also includes urethral-based masses such as urethral diverticula or cysts, carcinoma, and rarely leiomyoma. 13,14 Occasionally masses such as fibroids may occur in the anatomic space between the urethra and vagina without direct connection to either of these organs. 15 The correct clinical diagnosis of a vaginal fibroid is frequently overlooked in favor of the much more common urethral diverticulum.…”

A case of female large urethral diverticulum treated by electrofulguration

“… 1 The reported incidence of urethral diverticulum has varied from 1.4 to 5%, depending on the population studied. 1,2 The presenting symptoms of urethral diverticulum vary considerably and may mimic those of simple or chronic bacterial cystitis, pelvic inflammatory disease, endometriosis and detrusor instability, 1,2 and urologists often tend to misdiagnose this disease. In the present case, many years were required for diagnosis.…”

“…Several treatment methods have been described for urethral diverticulum, including transvaginal excision and endoscopic cauterization, saucerization and un‐roofing. 1,2,4 The transurethral procedure has some decided advantages over transvaginal diverticulectomy, 4 including: (i) less stress on the patient; (ii) easier technique for the surgeon; (iii) applic‐ability to most diverticula; (iv) repeatability without added difficulty; and (v) minimal danger of urinary incontinence and urethrovaginal fistula formation. Multiple large urethral diverticula can be safely managed by transurethral fulguration, as in the present case.…”