Abstract
A urethral diverticulum is a relatively uncommon finding. The estimated prevalence is approximately 1-5% in the general population. While the definitive treatment is surgical correction, there are limited studies guiding the best approach to repair. This is the case of a 48-year-old female who initially presented with vaginal discharge, dysuria, and dyspareunia. MRI revealed the diagnosis of suspected urethral diverticulum. The patient was treated with surgical correction with the aid of needle localization prior to the procedure. After the diverticulum was excised, the resulting defect in the urethra was successfully closed with cadaveric pericardial tissue. A urethral diverticulum should be considered in the differential diagnosis when a patient presents with symptoms such as recurrent urinary tract infections (UTIs) vaginal mass, dysuria, dyspareunia, or vaginal discharge. The use of cadaveric tissue augments the surgical technique for repair.
Highlights
A urethral diverticulum is defined as an abnormal outpouching of the urethral mucosa into the adjacent tissue
One proposed theory is that of chronic infection/inflammation of the periurethral glands resulting in abscess formation that can communicate with the urethral lumen [3]. Another proposed theory is that trauma via either surgical procedures, physical injury, or child birth may cause formation of urethral diverticula later in life [4,5,6]
This is the case of a 48-year-old G2P2002 who originally presented to our office in March 2016 with vaginal discharge, dysuria, and dyspareunia
Summary
A urethral diverticulum is defined as an abnormal outpouching of the urethral mucosa into the adjacent tissue. One proposed theory is that of chronic infection/inflammation of the periurethral glands resulting in abscess formation that can communicate with the urethral lumen [3]. Another proposed theory is that trauma via either surgical procedures (ex sling procedures), physical injury, or child birth may cause formation of urethral diverticula later in life [4,5,6]. Other common presenting symptoms include recurrent urinary tract infections, urethral stones, and tender vaginal mass [7, 8]. There are several known postoperative complications reported in the literature including urethral stricture, ureterovaginal fistula, stress incontinence, and recurrent UTIs [14]. The risk of complications increases with repeat procedures [15]
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