Urethral Diverticulum

What is a urethral diverticulum?

A urethral diverticulum is an outpouching from the tube called the urethra. The urethra is the tube that allows you to urinate.

Who usually gets a urethral diverticulum?

They are much more common in women than men. It can happen at any age but are seen most often between the ages of 30 -70. It is a rare condition and happens in about 5 out of 100,000 people.

What causes a urethral diverticulum?

There are glands in the urethra that get blocked (we don’t know why) and as a result of this you get an outpouching of the gland and this is called a urethral diverticulum

What are common signs and symptoms of urethral diverticulum?

  • Dysuria: stinging or burning when you pass urine.
  • Frequency: urinating a lot – less than every 2-3 hours.
  • Urgency: “got to go, got to go” feeling when you need to urinate.
  • Dyspareunia: pain with sex.
  • Post void dribbling: dribbling after you urinate.
  • Recurrent bladder infections: infections in the bladder that keep coming back
  • Urethral discharge: you might get a discharge from the tube you urinate from.

Your symptoms may come and go. They do not need to be there all the time. The problem with diverticulae is that many of the symptoms are not specific to the condition, so many patients may be misdiagnosed and treated inappropriately for years before the correct diagnosis is made.

How do you make the diagnosis of a urethral diverticulum?

Your doctor will take a complete history, and performs a detailed examination.

How does your doctor find this diverticulum?

On pelvic exam there is frequently a mass around the urethra that can be seen in the vagina. This mass can be tender to touch. Sometimes by pressing on it you can see pus coming from the urethral opening.

What testing may need to be done to help confirm the diagnosis of a urethral diverticulum?

If your doctor suspects that you have one, an MRI of the pelvis will be done which will help confirm the diagnosis and show the surgeon its exact location and size. Your surgeon will usually take a look into urethra and bladder with a telescope called a cystoscope

How is urethral diverticulum treated?

Some people have no symptoms at all. They can be followed for symptoms and do not need surgery. The reason to follow up is that a small number of people develop cancer inside the diverticulum. If this is happening it needs to be picked up as early as possible.

Definitive treatment is surgery, where the diverticulum is removed.  All surgeries come with some risks. The specific risks of this surgery include recurrence, and development of a fistula (hole between urethra and vagina that urine leaks through) and the development of urinary incontinence.

Surgery is usually done as a day surgery and you will usually go home on the same day. You will need a catheter for about 10 days after surgery and will need antibiotics after surgery.