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A urethral diverticula is described as a cystic structure that is adjacent to the urethra. It is thought to arise from the glands that are situated just next to the urethra. The prevalence is unknown, however it is reported to occur between 1% and 6% of adult females. Symptoms may include dysuria (burning with urination), dyspareunia (painful intercourse),, and dribbling after voiding. Other symptoms may include recurrent urinary tract infections, complaint of a vaginal mass, hematuria (blood in the urine), vaginal discharge, obstructive urinary symptoms or urinary incontinence. Some patients may not have any symptoms at all.
Urethral diverticula are thought to be congenital (present at birth) or acquired. Vaginal birth and trauma have been thought to contribute to the formation of a urethral diverticulum, where the urethral muscoa (inner layer) herniates through the muscular layers. Inflammation of the glands adjacent to the urethra have also been cited as a cause.
A complete evaluation includes a pelvic examination, urinalysis, cystoscopy and imaging. There are many different imaging modalities that may show the urethral diverticulum including a voiding cystourethrogram, ultrasound, and MRI. A urodynamics study may be obtained if the patient’s symptoms include urinary incontinence.
Excisional surgery is needed to remove a urethral diverticulum. These are complex vaginal reconstructive surgeries that should be undertaken by an experienced pelvic surgeon. At UCLA Urology, we have performed many excisional surgeries for urethral diverticula with excellent outcomes.
