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Shafat Heller L, Feiner B, Sharabi H, Brodner Y, Shrim A. Transvaginal ultrasound imaging of female urethral diverticulum before and after voiding. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:640-641. [PMID: 34396625 DOI: 10.1002/uog.23766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/31/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Affiliation(s)
- L Shafat Heller
- Obstetrics and Gynecology Department, Hellel Yaffe Medical Center, Hadera Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
| | - B Feiner
- Obstetrics and Gynecology Department, Hellel Yaffe Medical Center, Hadera Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
| | - H Sharabi
- Obstetrics and Gynecology Department, Hellel Yaffe Medical Center, Hadera Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
| | - Y Brodner
- Obstetrics and Gynecology Department, Hellel Yaffe Medical Center, Hadera Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
| | - A Shrim
- Obstetrics and Gynecology Department, Hellel Yaffe Medical Center, Hadera Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
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Sun Y, Tang C, Li N, Luo DY, Peng L, Shen H, Wei Q. Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women. Int Braz J Urol 2019; 45:1216-1226. [PMID: 31808411 PMCID: PMC6909855 DOI: 10.1590/s1677-5538.ibju.2018.0824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/11/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction and Objective: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD. Materials and Methods: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. Results: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. Conclusion: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.
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Affiliation(s)
- Yi Sun
- Department of Urology, Institution of Urology, West China Hospital, Sichuan University, Guoxue, Xiang, Chengdu, China
| | - Cai Tang
- Department of Urology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Na Li
- Department of Pediatrics, Chengdu Tianfu New District People's Hospital, Chengdu, China
| | - De-Yi Luo
- Department of Urology, Institution of Urology, West China Hospital, Sichuan University, Guoxue, Xiang, Chengdu, China
| | - Liao Peng
- Department of Urology, Institution of Urology, West China Hospital, Sichuan University, Guoxue, Xiang, Chengdu, China
| | - Hong Shen
- Department of Urology, Institution of Urology, West China Hospital, Sichuan University, Guoxue, Xiang, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institution of Urology, West China Hospital, Sichuan University, Guoxue, Xiang, Chengdu, China
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Livingston D, Rajan C, McKinney JM, Bhatt S. "Horseshoe" sign in a female urethral diverticulum. Abdom Radiol (NY) 2019; 44:2929-2930. [PMID: 30976826 DOI: 10.1007/s00261-019-02015-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Celin Rajan
- Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - J Mark McKinney
- Department of Radiology, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Shweta Bhatt
- Department of Radiology, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA.
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A Case of Urethral Diverticulum with Surgical Repair Using Cadaveric Pericardial Tissue. Case Rep Urol 2018; 2018:6183618. [PMID: 30519496 PMCID: PMC6241371 DOI: 10.1155/2018/6183618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/04/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022] Open
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.
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Johnson SC, Yegul NT, Balcacer P. Sonovaginography: A Useful Technique in the Assessment of the Lower Genital Tract. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1917-1933. [PMID: 28516503 DOI: 10.1002/jum.14216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 11/11/2016] [Indexed: 06/07/2023]
Abstract
Conventional sonographic evaluation of the cervix and vagina is compromised by inattention, poor subject contrast, and obscuring artifacts. We describe a technique involving distention of the vaginal canal and fornices with ultrasound gel, providing an acoustic window for improved definition of the cervix and vagina. This exam is usually performed in concert with transvaginal sonography, but a transabdominal or transperineal approach may be more useful in selected scenarios. A wide variety of formerly sonographically inconspicuous conditions are demonstrable with this technique, many of which were undetected or inadequately characterized on the physical exam. Cervical polyps were the most commonly seen abnormality.
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Affiliation(s)
- Samuel C Johnson
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - N Tugce Yegul
- Department of Radiology, Kaiser Permanente, Sacramento, California, USA
| | - Patricia Balcacer
- Department of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
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Three-dimensional volume rendering of pelvic models and paraurethral masses based on MRI cross-sectional images. Int Urogynecol J 2017; 28:1579-1587. [DOI: 10.1007/s00192-017-3317-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022]
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Ultrasonographic Features of Female Urethral Diverticula: A Retrospective Study of 25 Patients. Female Pelvic Med Reconstr Surg 2017; 23:343-347. [PMID: 28106654 DOI: 10.1097/spv.0000000000000378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This article summarizes the ultrasonographic features of female urethral diverticula on biplane transrectal ultrasound (B-TRUS). METHODS A retrospective study was performed with 25 consecutive women who were diagnosed and treated as having urethral diverticulum (UD) between January 2012 and March 2016. All the patients were preoperatively evaluated using B-TRUS. The number, location, configuration, size, and type of the UD on B-TRUS were assessed. RESULTS Twenty-eight diverticula were found on B-TRUS. Twenty-two patients had single diverticulum, whereas the other 3 had double diverticula. The locations included proximal (14%), mid (46%), and distal (40%) urethra. In transverse section, the configuration presented as round or oval (46%), and horseshoe-like or circumferential (54%). The maximal diameter of the 28 diverticula ranged from 3 to 48 mm. The types contained simple UD (36%) and complex UD (64%). Color blood flow signal could be detected in the septa, cystic wall, and solid mass, whereas negative in other areas inside the UD. CONCLUSIONS Various sonographic characters of female UD could be observed during the evaluation, including single or multiple diverticula, different sites, diverse shapes, and septa, calculi, or neoplasm inside diverticulum, all of which could be clearly displayed on B-TRUS.
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Bodner-Adler B, Halpern K, Hanzal E. Surgical management of urethral diverticula in women: a systematic review. Int Urogynecol J 2015; 27:993-1001. [PMID: 26564222 DOI: 10.1007/s00192-015-2862-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/28/2015] [Indexed: 11/30/2022]
Abstract
Urethral diverticula (UD) are pouch-like outgrowths of the urethral lumen and surgery is by far the most common approach in symptomatic patients. The aim of this systematic review was to evaluate surgical techniques and outcomes in adult women with urethral diverticula. Our secondary objective was to determine the types of study designs. A systematic review of the literature was conducted. Medline, Cinahl and Embase were used as data sources. One hundred and eight studies, including 1,947 patients, remained for final analysis. We summarised 40 single case reports and 68 case series. Overall, transvaginal resection of the UD ± reconstruction was performed in the majority of patients (84 %), followed by marsupialisation (3.8 %) and transurethral endoscopic unroofing (2.0 %). Various other surgical techniques were reported in 181 out of 1,858 cases (9.7 %). Nineteen studies, dealing with 584 patients in all, evaluated a combination of vaginal diverticulectomy with an additional surgical procedure. Fifty-six out of 108 studies (52 %) documented the resolution of symptoms, describing 717 out of 1,044 patients in all being completely symptom-free after surgery. Only 50 out of 108 studies (46.2 %) provided detailed information on the length of follow-up, but showed a poor reporting standard regarding prognosis. Complications were studied only selectively. Because of the inconsistency of these data, it was impossible to analyse them collectively. There were no comparative studies on the different types of surgery in women with urethral diverticula. Overall, the non-comparative nature of the current evidence on the surgical management of UD does not allow any accurate estimation of success and complication rates.
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Affiliation(s)
- Barbara Bodner-Adler
- Department of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Ksenia Halpern
- Department of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Engelbert Hanzal
- Department of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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Affiliation(s)
- Rosemary Archer
- Department of Obstetrics and Gynaecology; Torbay Hospital; Torquay Devon TQ2 7AA UK
| | - Jennifer Blackman
- Department of Obstetrics and Gynaecology; Torbay Hospital; Torquay Devon TQ2 7AA UK
| | - Mark Stott
- Department of Urology; Royal Devon and Exeter Hospital; Exeter Devon EX2 5DW UK
| | - Julian Barrington
- Department of Obstetrics and Gynaecology; Torbay Hospital; Torquay Devon TQ2 7AA UK
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Lee YJ, Son SJ, Paick JS, Kim SW. Preoperative CT voiding cystourethrography using 16-multidetector CT in female urethral diverticulum. PLoS One 2014; 9:e107448. [PMID: 25216189 PMCID: PMC4162593 DOI: 10.1371/journal.pone.0107448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/11/2014] [Indexed: 11/27/2022] Open
Abstract
Purpose To evaluate the clinical usefulness of preoperative CT voiding cystourethrography (CT-VCUG) using 16-multidetector computed tomography for female urethral diverticula. Materials and Methods Preoperative CT-VCUG was performed in 15 consecutive patients who underwent urethral diverticulectomy from May 2004 to December 2012. The result of preoperative cystourethroscopy and surgical findings were recorded by a single surgeon and CT-VCUG findings including the location of osita were retrospectively reviewed by another urologist who was blinded to the surgical finding. The location of the ostium detected on CT-VCUG was compared descriptively with the intraoperative surgical and preoperative cystourethroscopic findings. Results A total of 14 consecutive patients who underwent preoperative CT-VCUG and urethral diverticulectomy were included in the analysis. Ostia were detected on CT-VCUG in all cases, whereas ostia were identified in 10 patients (71.4%) by cystourethroscopy. Ostia were located between the 4 and 8 o’clock direction. Mean distance from the bladder neck to the ostium was 24.2 mm. Circumferential and horseshoe shaped diverticula were observed in 6 and 4 patients, respectively. The surgical findings correlated well with the CT findings. Conclusions Preoperative CT-VCUG can be useful in identifying the ostia of urethral diverticula in patients scheduled for urethral diverticulectomy and can provide structural information, useful to establish surgical strategy.
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Affiliation(s)
- Young Ju Lee
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Seung Jun Son
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Jae-Seung Paick
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
- * E-mail:
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Singla P, Long SS, Long CM, Genadry RR, Macura KJ. Imaging of the female urethral diverticulum. Clin Radiol 2013; 68:e418-25. [PMID: 23561897 DOI: 10.1016/j.crad.2013.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/04/2013] [Accepted: 02/19/2013] [Indexed: 11/30/2022]
Abstract
Female urethral diverticulum is a localized out-pouching of the urethra that is becoming increasingly prevalent, but often poses a diagnostic challenge. Traditionally, conventional voiding cystourethrography has been used to make the preoperative diagnosis. With the development of higher-resolution images acquired through ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), the anatomy and various abnormalities of the female urethra can be better elucidated. This article focuses on the imaging features of female urethral diverticulum, with emphasis on diagnostic pearls, particularly using MRI. Female urethral diverticulum can be best identified by their location in the posterolateral urethra and by their communication with the urethral lumen. Improved imaging techniques combined with increased physician awareness of urethral diverticulum will lead to more prompt and accurate diagnosis of this entity, leading to better treatment of affected patients.
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Affiliation(s)
- P Singla
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
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MRI Evaluation of Urethral Diverticula and Differential Diagnosis in Symptomatic Women. AJR Am J Roentgenol 2011; 197:676-82. [DOI: 10.2214/ajr.10.6144] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Surgically Corrected Urethral Diverticula: Long-term Voiding Dysfunction and Reoperation Rates. Urology 2011; 77:65-9. [DOI: 10.1016/j.urology.2010.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 05/27/2010] [Accepted: 06/04/2010] [Indexed: 11/19/2022]
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Wu YY, Li YZ, Wei Q, Li H, Hang GY, Shen H. Transvaginal sonographic diagnosis of female urethral diverticula. JOURNAL OF CLINICAL ULTRASOUND : JCU 2009; 37:40-42. [PMID: 18803310 DOI: 10.1002/jcu.20527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE We report our experience with transvaginal sonography (TVUS) in the diagnosis of female urethral diverticulum (UD). METHOD We reviewed the TVUS examinations of 4 patients with a clinical diagnosis of UD and correlated the sonographic findings with the operative findings, especially regarding the UD's size, content, and location. RESULTS All UDs were demonstrated on TVUS. The size, content, and location of the UD correlated well with the operative findings. CONCLUSION TVUS is accurate in diagnosis and determination of the size, content, and location of female UD.
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Affiliation(s)
- Yong-Yang Wu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
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Chou CP, Levenson RB, Elsayes KM, Lin YH, Fu TY, Chiu YS, Huang JS, Pan HB. Imaging of Female Urethral Diverticulum: An Update. Radiographics 2008; 28:1917-30. [DOI: 10.1148/rg.287075076] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Stav K, Dwyer PL, Rosamilia A, Chao F. Urinary Symptoms Before and After Female Urethral Diverticulectomy—Can We Predict De Novo Stress Urinary Incontinence? J Urol 2008; 180:2088-90. [DOI: 10.1016/j.juro.2008.07.049] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Indexed: 11/17/2022]
Affiliation(s)
- Kobi Stav
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Australia
- Department of Urology, Assaf Harofeh Medical Center, Zeriffin, and Sackler School of Medicine, Tel Aviv University, Israel
| | - Peter L. Dwyer
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Australia
| | | | - Fay Chao
- Monash Medical Centre, Melbourne, Australia
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the presentation, investigation and management of female urethral diverticulum, a condition often overlooked and frequently misdiagnosed. Hopefully, greater awareness will lead to more timely diagnosis and appropriate treatment. RECENT FINDINGS Recently there has been considerable emphasis on correctly identifying this condition. Newer imaging modalities such as magnetic resonance imaging are now widely available and urethral diverticula that previously were unrecognized, such as noncommunicating diverticula, can now be more easily detected. The character of the diverticula can be accurately determined with appropriate imaging and this can lead to improved preoperative planning. SUMMARY Traditional contrast studies are now being superseded by advanced cross-sectional imaging such as magnetic resonance imaging and even virtual computed tomography urethroscopy. These provide much greater tissue definition; however, very few studies directly compare the myriad of contrast-based, ultrasonographic and cross-sectional investigations that are available. Therefore, although the condition is eminently treatable, there remains little standardization in the investigation of this condition. The greatest single improvement, however, in management would come from more widespread clinical awareness of the condition and its presentation.
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Affiliation(s)
- Anand K Patel
- Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Yang JM, Huang WC, Yang SH. Transvaginal sonography in the diagnosis, management and follow-up of complex paraurethral abnormalities. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 25:302-306. [PMID: 15693039 DOI: 10.1002/uog.1811] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Most urethral diverticula are thought to result from infection and obstruction of the paraurethral ducts and glands. When rupture of a resulting retention cyst or abscess occurs into the urethra, a diverticulum is formed. We report two cases of paraurethral abnormalities: urethral diverticulum and paraurethral abscess. Transvaginal sonography, with its high-resolution visualization of the lower urinary tract, may aid in the diagnosis and treatment of such disorders. Using three-dimensional technology, the internal architecture of the paraurethral abnormalities and their spatial relationship to the urethra and bladder, important considerations at surgery, are clearly demonstrated on ultrasonography. Complete excision of complex paraurethral anomalies may be performed under transvaginal sonographic monitoring without inadvertent injury to the bladder or urethra.
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Affiliation(s)
- J-M Yang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
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Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G. Periurethral Masses: Etiology and Diagnosis in a Large Series of Women. Obstet Gynecol 2004; 103:842-7. [PMID: 15121554 DOI: 10.1097/01.aog.0000124848.63750.e6] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the differential diagnosis of periurethral masses in a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS Seventy-nine (4%) patients aged 41.2 +/- 14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95% confidence interval [CI] 73%, 91%) had urethral diverticula, of which 4 (6%; 95% CI 2%, 14.8%) contained malignancies. Six patients (7%; 95% CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95% CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95% CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95% CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95% CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n = 32). CONCLUSION Periurethral masses were encountered in less than 4% of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.
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Affiliation(s)
- Jerry G Blaivas
- Joan and Sanford Weill College of Medicine, Cornell University, New York, New York 10021, USA.
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