Urethral Diverticula in Women: Discrepancies Between Magnetic Resonance Imaging and Surgical Findings

Abstract

In cases clinically suspicious for urethral diverticulum magnetic resonance imaging had a 24.4% error rate. Serious consequences are failure to detect cancer and suboptimal treatment for urethral diverticulum. The reason for the high magnetic resonance imaging accuracy rate in other series may be that in the absence of radiological confirmation some surgeons may choose not to perform surgery. Magnetic resonance imaging is useful to assess urethral diverticula but physicians should be aware of its limitations.

Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses

“…When imaging was performed by using high resolution techniques, MRI accuracy improved to 81.8%. The overall accuracy rate in our study is comparable to that of Chung et al [15], who found a 24.4% error rate for MRI when examining for urethral diverticula compared to surgical diagnosis. In these cases, MRI often underdiagnosed diverticula or missed a urethral malignancy [15].…”

“…The overall accuracy rate in our study is comparable to that of Chung et al [15], who found a 24.4% error rate for MRI when examining for urethral diverticula compared to surgical diagnosis. In these cases, MRI often underdiagnosed diverticula or missed a urethral malignancy [15]. This may be related to mass size fluctuation or lack of fluid distending the diverticulum [15].…”

“…In these cases, MRI often underdiagnosed diverticula or missed a urethral malignancy [15]. This may be related to mass size fluctuation or lack of fluid distending the diverticulum [15]. Kim et al [4] also found that MRI accurately diagnosed 70% of diverticula compared to pathology reports, often failing to locate the ostium of the diverticulum.…”

“…Kim et al [4] also found that MRI accurately diagnosed 70% of diverticula compared to pathology reports, often failing to locate the ostium of the diverticulum. It seems that MRI should be done in combination with other work-up, most likely physical exam and cystourethroscopy [15]. Cost-effectiveness studies may provide additional information about the best combination of these tests.…”

Preoperative CT Voiding Cystourethrography Using 16-Multidetector CT in Female Urethral Diverticulum

“…However, Chung et al reported that in cases of clinically suspicious urethral diverticula, 24.4% of patients showed substantial discrepancy between the operative findings and the results of MRI. In their study, 2 patients had a major discrepancy regarding the site or anatomy of urethral diverticulum, which made intraoperative decision difficult [16]. Furthermore, in a view of ostia, MRI does not provide excellent sensitivity.…”