Female Urethral Diverticulum: Presentation, Diagnosis, and Predictors of Outcomes After Surgery

El-Nashar, Sherif A.; Singh, Rashmi B. Halker; Bacon, Melissa M.; Kim-Fine, Shunaha; Occhino, John A.; Gebhart, John B.; Klingele, Christopher J.

doi:10.1097/spv.0000000000000312

Cited by 23 publications

(2 citation statements)

References 16 publications

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“…These generally include urethral diverticulum, urethral strictures, and urethral trauma. 1 , 8 The latter is one of the most common etiologies because of obstetrical complications. 1 , 2 , 8 …”

Section: Indications Contraindications and Cautionsmentioning

confidence: 99%

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Urethrocystography: a guide for urological surgery?

Freitas¹,

Alves²,

Correia³

et al. 2023

Diagn Interv Radiol

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Urethrocystography remains the gold-standard technique for urethral pathology diagnosis. Nowadays, of the various indications for performing urethrocystography, the most common is due to a clinical suspicion of urethral stricture. Due to the high prevalence of strictures and their substantial impact on a patient's quality of life, the examination must allow the location, exclusion of multifocality, and assessment of the extent of the stricture to influence surgical planning. This article intends to demonstrate that the radiologist's role, by performing and interpreting the modality of urethrocystography, influences and is crucial for the urologic therapeutic decision and that the patients who were submitted to reconstruction by urethroplasty had a better success rate. The authors aim to review the radiological anatomy of the male urethra, discuss the modalities of choice for imaging the urethra (retrograde urethrography and voiding cystourethrography), provide an overview of the different indications for performing the study, examine the different etiologies for urethral strictures, understand the relevance of the different appearances of urethral pathology, and identify the surgical options, especially in the treatment of urethral strictures. Simultaneously, the study exposes cases of urethral trauma, fistulas, diverticulum, and congenital abnormalities.

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Section: Indications Contraindications and Cautionsmentioning

confidence: 99%

“… 1 , 8 The latter is one of the most common etiologies because of obstetrical complications. 1 , 2 , 8 …”

Section: Indications Contraindications and Cautionsmentioning

confidence: 99%

Urethrocystography: a guide for urological surgery?

Freitas¹,

Alves²,

Correia³

et al. 2023

Diagn Interv Radiol

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Preoperative Transurethral Contrast‐Enhanced Ultrasonography in the Diagnosis of Female Urethral Diverticula

Wang

Dou

Yao

et al. 2018

J of Ultrasound Medicine

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Urethral diverticula in women are associated with increased urethra‐sphincter complex volumes: A potential role for high‐tone nonrelaxing sphincter in their etiology?

Mukhtar

Solomon

Naaseri

et al. 2019

Neurourology and Urodynamics

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Aims: Functional obstruction secondary to a high-tone nonrelaxing sphincter (HTNRS) may lead to the formation of a proximal-to-mid-urethral diverticulum (pmUD) in patients without a history of anatomical obstruction, vaginal delivery, vaginal and/or urethral surgery, or periurethral gland infection, that is, a functional pmUD (fpmUD). We used measurements of the urethra-sphincter complex volume (USCv) as a proxy for the maximal urethral closure pressure to evaluate this potential etiological factor. Methods: We compared 17 consecutive women with fpmUD (mean age ± SD of 49.4 ± 13.2 years) with a control group consisting of 24 age-matched women (mean age: 50.8 ± 11.2 years) with no previous urological symptoms having MRI for posthysterectomy vesicovaginal fistula, and in all 71 women (mean age: 48.1 ± 11.6 years) with classical urethral diverticulum (cpmUD) referred in the same time period. The urethra-sphincter complex was measured using T2-weighted MRI and OsiriX © was then used to determine the USCv.Results: The mean USCv of the fpmUD group was 10.01 ± 6.97 cm 3 . The mean USCv of the cpmUD was 5.19 ± 1.19 cm 3 and for the control group was 3.92 ± 1.60 cm 3 . There was a high statistically significant (P = .01) difference between the USCv in the fpmUD group and the USCv of both the cpmUD and the control groups.Conclusions: Women with fpmUD demonstrated USCv that were significantly higher than those in women with cpmUD and the control group. These findings suggest that high pressure in the proximal urethra during voiding secondary to a HTNRS may contribute to the formation of urethral diverticula. K E Y W O R D Shigh-tone nonrelaxing sphincter, MRI volume, sphincter complex, urethral diverticulum

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Female Urethral Diverticulum: Presentation, Diagnosis, and Predictors of Outcomes After Surgery

Cited by 23 publications

References 16 publications

Urethrocystography: a guide for urological surgery?

Urethrocystography: a guide for urological surgery?

Preoperative Transurethral Contrast‐Enhanced Ultrasonography in the Diagnosis of Female Urethral Diverticula

Urethral diverticula in women are associated with increased urethra‐sphincter complex volumes: A potential role for high‐tone nonrelaxing sphincter in their etiology?

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