Transvaginal Ultrasound for the Diagnosis of Urethral Diverticulum

Gerrard, Edward R.; Lloyd, L. Keith; Kubricht, William S.; Kolettis, Peter N.

doi:10.1097/01.ju.0000056739.53193.6c

Cited by 42 publications

(20 citation statements)

References 6 publications

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“…Some radiographic images, e.g. ultrasound, voiding cystourethrography (VCUG), doubleballoon urethrography, MRI and the new method of virtual CT urethroscopy, also help to diagnose female urethral diverticulum [7][8][9][10] . However, which modality is the most accurate remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Chang

Lin

Chen³

2008

Urol Int

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Introduction: Symptoms or signs of female urethral diverticulum are usually not typical, thereby resulting in delayed or wrong diagnosis. This paper relates to our experience on the diversity of presenting symptoms and signs of female urethral diverticula. Materials and Methods: We reviewed the medical records and conducted telephone interviews of 14 patients with the diagnosis of female urethral diverticulum in our institution. Results: The mean patient age at diagnosis was 47.5 years (range 22–65 years) and the mean duration between symptom presentation and diagnosis was 6.46 years (range 1 month to 30 years). Their presenting symptoms were so diverse that many were initially treated under the diagnosis other than urethral diverticulum. Most patients were treated as uncomplicated urinary tract infection for a long time. Stress urinary incontinence (SUI) was so dominant in 2 patients with big diverticula that they were falsely treated with anti-incontinence surgery. Total incontinence happened in 1 patient with genuine SUI and a big urethral diverticulum. One patient with a huge diverticulum, which had a fistula opening into the vagina, presented with day- and night-time incontinence. Some patients even did not have incontinence, but only had dysuria or a painful anterior vaginal wall nodule. Nevertheless, detailed analysis on symptoms and signs usually may suggest urethral diverticulum. We found that recurrent urinary tract infection, urinary incontinence, palpable suburethral mass, vaginal tenderness, and dysuria are the five major presenting symptoms and signs. The diagnostic rate of voiding cystourethrography during video-urodynamics, double-balloon urethrography and MRI were 10/10 (100%), 6/6 (100%) and 10/11 (90.9%) respectively. Conclusions: The presenting symptoms and signs of female urethral diverticula are often diverse and easily overlooked. High suspicion of this disorder, detailed history-taking and physical examination are essential for detecting urethral diverticulum in females.

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Section: Introductionmentioning

confidence: 99%

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Chang

Lin

Chen³

2008

Urol Int

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“…Furthermore, if a diverticulum cannot be excluded based on physical examination, TVS may help differentiate between both entities. TVS has been shown to be effective in diagnosing urethral diverticula [11][12][13][14] . Compared with VCUG, Siegel et al [12] found that TVS was able to identify the neck of the diverticula in 13 of 15 diverticuli (87%), whereas VCUG only identified 2 of 13 (15%).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Periurethral Cysts

Lucioni¹,

Rapp²,

Gong³

et al. 2007

Urol Int

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Background/Aims: Periurethral cysts are a rare entity that may be confused with urethral diverticula. The protocol for diagnosis and management of these lesions is still unclear. We present our experience with six patients presenting with periurethral cysts. Methods: From 2001 to 2005 we evaluated six patients with a paraurethral mass. History, physical examination, laboratory and radiographic findings were analyzed to determine factors helpful in mass diagnosis. Cyst excision was performed via trans-vaginal approach in all patients and outcomes of this approach were assessed. Results: Six female patients, average age of 29.7 years, presented with the complaint of a paraurethral mass. Transvaginal sonography was performed in two patients to confirm the presence of a periurethral cyst. Cystourethroscopy in all patients revealed no communication between the cyst and the urethra or presence of other lesions. Pathology revealed a benign cyst in all patients. No cyst recurrence has been seen in any patient. Conclusion: Most periurethral cysts can be diagnosed by physical examination. The diagnosis may be confirmed with transvaginal sonography. Cystourethroscopy should be performed to rule out other pathology, but may be done in the same setting as surgical excision. Complete surgical excision is effective and is associated with minimal risk of recurrence during short-term follow-up.

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“…5,6 TVUS is inexpensive, noninvasive, and readily available in almost all urology and gynecology departments. It is rapid and easy to perform, and it provides the physician the advantage of real-time, hands-on evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, double balloon urethrography, voiding cystourethrography (VCUG), and MRI [2][3][4] are the most commonly used modalities in the preoperative evaluation of UD. Recently, transrectal 5 and transvaginal 6,7 scanning have been used effectively to demonstrate UDs. We reported our experience with TVUS in 4 women in confirming the diagnosis of UD and comparing the size, location, and content with operative findings.…”

mentioning

confidence: 99%

Transvaginal sonographic diagnosis of female urethral diverticula

Wang

et al. 2008

J of Clinical Ultrasound

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Purpose. We report our experience with transvaginal sonography (TVUS) in the diagnosis of female urethral diverticulum (UD).Method. We reviewed the TVUS examinations of 4 patients with a clinical diagnosis of UD and correlated the sonographic findings with the operative findings, especially regarding the UD's size, content, and location.Results. All UDs were demonstrated on TVUS. The size, content, and location of the UD correlated well with the operative findings.Conclusion. TVUS is accurate in diagnosis and determination of the size, content, and location of female UD.

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Transvaginal Ultrasound for the Diagnosis of Urethral Diverticulum

Abstract: Transvaginal ultrasound is effective for evaluating patients with suspected urethral diverticulum. It is less expensive and may identify diverticula missed by other diagnostic modalities.

Cited by 42 publications

References 6 publications

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Presentation of Female Urethral Diverticulum Is Usually Not Typical

Diagnosis and Management of Periurethral Cysts

Transvaginal sonographic diagnosis of female urethral diverticula

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