Urethral Diverticulum

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Urethral Diverticulum

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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. Signs and symptoms suggesting a UD may also include:

  • Painful intercourse (dyspareunia)
  • Burning sensations during urination (dysuria)
  • Bloody or cloudy urine
  • Leaking caused by acts such as sneezing or coughing (urinary incontinence)
  • Frequent urination or difficulty urinating

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What Causes a Urethral Diverticulum?

It’s believed many urethral diverticulums are related to conditions present at birth (congenital). Some UDs may also be acquired. Sacs sometimes develop as a result of vaginal childbirth. In some instances, urethral glands may become blocked and contribute to a UD forming. Multiple infections can also weaken the uterine wall over time and create optimal conditions for a UD.

Diagnosis

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

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. 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. 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. What patients can do, however, is practice good hygiene habits and take steps that may minimize the risk of developing an infection. This means drinking plenty of water, maintaining a healthy weight, and avoiding acidic foods, excessive consumption of alcohol and caffeinated beverages, and other foods and drinks that may irritate the bladder or urethra. It’s just as important to be mindful of any symptoms that suggest an infection to minimize the risk of problems developing in other parts of the urinary or reproductive system.

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