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Anterior Urethral Diverticulum in the Female: Diagnosis and Surgical Approach

Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

Address reprint requests to: Babak Vakili, MD, Louisiana State University Health Sciences Center, Department of Obstetrics and Gynecology, 1542 Tulane Avenue, 5th Floor New Orleans, LA 70112; E-mail: bvakil{at}lsuhsc.edu.

ABSTRACT

BACKGROUND: Despite an incidence of 3–40% in different populations, a diagnosis of urethral diverticulum in female patients is often delayed or missed.

CASE: A 49-year-old multiparous woman presented complaining of severe, refractory urinary urgency and frequency and urge incontinence, in addition to dysuria and pelvic pain for several years. The diagnosis of an anterior urethral diverticulum was made based on findings at magnetic resonance imaging. Surgical management was accomplished vaginally without significant urethral disruption. At 5 months postoperatively, the patient was markedly improved.

CONCLUSION: Lower urinary tract pathology can create a diagnostic and surgical dilemma, which necessitates a thorough evaluation and careful management to achieve a satisfactory outcome.