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Urethral diverticulum refers to a pocket or pouch that forms in the urethral wall, the tube responsible for carrying urine from the bladder out of the body. It occurs when the urethral glands become obstructed, leading to the accumulation of urine in a localized area. This condition is relatively uncommon but can cause various urinary symptoms and discomfort. These can include pain with urination, or dysuria, pain during sex or dyspareunia, urinary leakage or dribbling, or recurrent urinary tract infections. You can often see a urethral diverticulum if looking in the vagina with a mirror at the top of the vagina underneath the urethra (pee tube).
The exact cause of urethral diverticulum is not always clear, but several factors may contribute to its development. These include:
1. Chronic inflammation or infection of the urethra.
2. Trauma or injury to the urethral area.
3. Previous surgical procedures affecting the urethra.
4. Weakening of the urethral tissues, possibly due to hormonal changes or aging.
1. Medical History and Physical Examination: Your doctor will discuss your symptoms and medical history, followed by a physical examination of the pelvic area to check for any abnormalities. Usually this is using a half speculum to see the anterior vaginal wall
2. Imaging Tests: Imaging techniques such as ultrasound or magnetic resonance imaging (MRI) scans may be used to visualize the diverticulum and assess its size, location, and potential abnormalities within the diverticulum
3. Voiding Cystourethrography (VCUG): This diagnostic procedure involves injecting a contrast dye into the bladder and urethra while taking X-ray images during urination. It helps identify diverticulum and any associated abnormalities in the urinary system.
4. Cystoscopy: During a cystoscopy, a thin tube with a camera (cystoscope) is inserted into the urethra to visualize the urethral diverticulum directly. This procedure allows for better evaluation of the diverticulum’s characteristics and helps guide treatment decisions.
The management of urethral diverticulum depends on various factors such as the size, location, and severity of symptoms. Treatment options may include:
1. Watchful Waiting: In cases where the diverticulum is small, asymptomatic, and does not have any concerning abnormalities, a conservative approach of monitoring the condition may be recommended. This often requires regular imaging as there are rare occurrences of cancer developing in urethral diverticulum.
2. Medication: Antibiotics or other medications can be prescribed to manage any associated infections.
3. Surgical Intervention: If symptoms are severe or complications arise, surgical intervention is usually necessary. The specific surgical procedure often is doen vaginally and involves diverticulum excision, repair of the urethral defect, and reconstruction of the urethral wall.
Urethral diverticulum is a relatively uncommon condition that can cause urinary symptoms and discomfort. Seeking medical attention and proper diagnosis is essential for effective management. Treatment options range from watchful waiting to surgical intervention, depending on symptoms and personal preference.
Contact Dr. Malik for speaking engagements, press partnerships, or collaborations
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Out-of-State telehealth provider for Florida
