Female urethral diverticula: From pathogenesis to management. An update

Abstract

Urethral diverticulum, a sac-like protrusion communicating with the urethral lumen, is a relatively uncommon occurrence. It represents either an infected paraurethral gland that has ruptured in the urethra or a prolapse of the urethral wall through a defect in the periurethral fascia. The classic clinical presentation is a soft, slightly tender vaginal lesion causing dysuria, dyspareunia and dribbling incontinence. Unfortunately, this classic presentation is only seldom seen. The condition may be either asymptomatic or manifest nonspecific symptoms of any lower genitourinary tract pathology. In the majority of cases, diagnosis relies on imaging, with MRI becoming the technique of choice, as it is accurate and provides detailed anatomical information. Complete excision of the diverticular sac with meticulous urethral and periurethral reconstruction is the 'gold standard treatment. Success rates of 70-100% have been reported, with a few complications occurring, particularly in cases of large and complex diverticula. © 2010 Expert Reviews Ltd.