Diagnosis of a female urethral diverticulum using transvaginal contrast‐enhanced sonourethrography

Abstract

The diagnosis of female urethral diverticulum is difficult due to its nonspecific symptoms, and invasive diagnostic procedures are often necessary. We report a case in which the diagnosis was made with contrast-enhanced transvaginal sonourethrography. The microbubble contrast agent could be seen filling the diverticular cavity via its opening.

Urethral Diverticulum in Women: Retrospective Case Series

“…There have been a number of studies claiming various modalities of imaging [12]. However, this study confirms that MRI imaging is the best way of assessing the presence of urethral diverticula in women, which concurs with the majority of the other studies [10,11,13,14].…”

“…MRI is probably the most sensitive method of securing a diagnosis when traditional workup of a vaginal wall mass has yielded inconclusive results [10,11]. T2-weighted images are more effective with urethral diverticula because the lumen appears hyper dense [11,12].…”

“…Based on the literature review [11,12] and also on our own experience, we proposed that 6 mm is the cutoff for differentiating the urethral diverticulum into smaller and larger size. Despite the fact that the Group B is easy to diagnose by clinical examination, all of the women with the smaller diverticulum were symptomatic.…”

Odpowiedź na zagadkę ze str. 105

“…A definite diagnosis of a urethral diverticulum requires imaging its neck and filling it with contrast which may be urine itself during voiding sonourethrography. Recently, a paper has been published ( 3 ) which demonstrates that a diluted second-generation ultrasound contrast agent may be used for this purpose (1 ml of SonoVue in 50 ml of physiological saline). However, when inflammation of the diverticulum is present or when its neck is filled with amorphous content, the examination will fail.…”

“…Finally, it must be added that the mean time needed for the diagnosis of diverticula of the urethra amounts to 5.2 years. In this period, patients are examined by 9 physicians ( 3 ) . To conclude: When unexplained dysuria is present in female patients, urethral pathology should be considered in each case.…”