Urethral Diverticulum
A urethral diverticulum can lead to painful and embarrassing symptoms.
If a pocket, sac, or pouch forms in the tube that takes urine out of the body (urethra), it’s referred to as a urethral diverticulum (UD). This sac sometimes becomes filled with urine or pus. It’s when this happens that a UD may lead to an infection and initial symptoms similar to what’s experienced with a urinary tract infection.
- While considered rare, a UD is more likely to occur in women.
- A urologist often recommends surgery to treat a UD, especially if the resulting infection is serious, recurring, or affecting nearby structures.
Signs and Symptoms of Urethral Diverticulum
A urethral diverticulum may not produce any symptoms at first. It’s when an infection develops that symptoms usually become more noticeable and potentially serious. Patients usually first notice recurring UTIs or bladder infections.
Symptoms may not appear immediately
Infections often make symptoms more noticeable
Recurrent urinary tract infections are a common first sign
Common Symptoms
Additional symptoms may appear when infection or irritation develops. Signs and symptoms suggesting a urethral diverticulum may include:
1
Painful intercourse (dyspareunia)
2
Burning sensations during urination (dysuria)
3
Bloody or cloudy urine
4
Leaking caused by acts such as sneezing or coughing (urinary incontinence)
5
Frequent urination or difficulty urinating
What Causes a Urethral Diverticulum?
Sacs sometimes develop as a result of vaginal childbirth
Blocked urethral glands may contribute to a diverticulum forming
Multiple infections may weaken the urethral wall over time
These changes can create optimal conditions for a UD
It’s believed many urethral diverticulums are related to conditions present at birth (congenital). Some UDs may also be acquired.
Diagnosis
Symptoms often resemble urinary tract infections
Tests help confirm the presence of a diverticulum
Imaging studies may be used during evaluation
Bladder function testing may also be performed
It can be difficult to diagnose a UD from symptoms alone, since many other urological conditions have similar symptoms. In some cases, initial treatment recommendations may be made based on the assumption that the problem is a urinary tract infection. If initial treatments aren’t effective, a urologist may order a urine test and perform an endoscopic examination of the bladder and urethra.
With a voiding cystourethrogram, an X-ray study is done while the bladder is emptying. Contrast dye is used to provide a better view of the bladder on the images produced. An ultrasound and MRI scan may also be done. If urinary incontinence is experienced, a urodynamics study is sometimes conducted. This is an assessment of how well the bladder and urethra are functioning.
Treatment Options
1
Monitoring and Surgical Treatment
If symptoms aren’t serious, a urologist may recommend periodic monitoring. In most cases, the recommended treatment for a urethral diverticulum is removal of the sac or pouch.
2
Surgical Procedures
Options with UD surgery include opening the top part of the sac, removing the lining of the sac, closing off a connection to the urethra in the diverticular neck, or setting up the pouch so that it opens into the vagina. Another possibility is a diverticulectomy, which is complete removal of the UD.
3
Recovery and Prevention
It usually takes 2–3 weeks to recover from surgery for a UD. For patients also experiencing urinary incontinence, steps may be taken during UD surgery to stop urine leaks. A urethral diverticulum isn’t always preventable, but practicing good hygiene habits, drinking plenty of water, maintaining a healthy weight, avoiding acidic foods and excessive alcohol or caffeine, and monitoring symptoms that suggest infection may help reduce complications.