Exxcellence pearls: urethral diverticula

Question 0

What historical features are common for urethral diverticula?

Answer 0

Dysuria, frequency, urgency, hematuria. Some present with a vaginal lump or dyspareunia or painful ambulation.

Question 1

What is the most common etiology of urethral diverticula?

Answer 1

Infection of tubular peri-urethral glands followed by abscess formation with eventual breakthrough into the urethra lumen. The abscess walls form the pouch.

Question 2

How should asymptomatic urethral diverticula be managed?

Answer 2

Expectantly to do a complication rate neighboring 20%.

Question 3

How is urethral diverticula confirmed on physical exam?

What imaging can confirm?

Answer 3

Milking of the urethra can cause urine or exudate from the urethral meatus.

CT urethrogram (with contrast)

Question 4

How are most diverticula repaired and managed postoperatively?

Answer 4

Surgical excision with a layered closure over the urethra. A urethral catheter then serves as a stent for several weeks.