Urethral diverticulum: a recondite disease

Urethral diverticulum in females

Thirteen cases of urethral diverticulum in females are reported. Symptoms were non-specific. Two cases presented with suppuration in previously undiagnosed diverticula. The most important physical sign was palpation of the sac on vaginal examination. Micturating cystourethrography was the most useful investigation. An association with carcinoma makes excision mandatory and in 10 cases this was performed by a vaginal approach. A laterally based flap incision is described which was used in 7 cases without complication. In one case the diverticulum recurred after 5 years and was removed in the same way. Two cases that presented with suppuration were treated by incision and drainage: in one the diverticulum re-formed and the other case was lost to follow-up. The aetiology of the condition is unknown but we believe, on histological evidence, that it is congenital.