Urethral Diverticulum

Urethral diverticulum (UD) forms as a sac-like pouch along the urethra, primarily affecting women due to weakened urethral walls or obstructed periurethral glands. Common causes include recurrent urinary tract infections (UTIs) leading to gland blockage and rupture into the urethral lumen, trauma from childbirth, or rarely congenital defects; symptoms often emerge as the "3 Ds": dysuria (painful urination), dyspareunia (painful intercourse), and post-void dribbling.

Patients frequently experience recurrent UTIs, pelvic pain, urinary frequency/urgency, incontinence, hematuria, or a palpable vaginal mass that expresses pus or urine upon compression. Diagnosis involves detailed history, pelvic exam, imaging like MRI or ultrasound, and cystoscopy to visualize the diverticulum's size, location, and contents. Asymptomatic cases may warrant observation, but symptomatic UD typically requires surgical excision via transvaginal approach, often with martius flap reinforcement for complex cases, yielding high success rates in restoring normal voiding and preventing recurrence.?