A urethral diverticulum is a pocket or sac that forms along the urethra. Although the exact cause of urethral diverticula is not known, they are likely due to repeated infections in a periurethral gland that ultimately results in blockage. The blocked gland then likely bursts into the urethra creating the communication between the sac and the urethra. This condition is felt to be acquired rather than congenital (these are rarely if ever seen in babies).
Women with urethral diverticulum may experience postvoid dribbling (drips after urinating), dysuria (burning with urination), and dyspareunia (pain with intercourse). In addition, women may experience, chronic or recurrent urinary tract infections, urinary frequency and/or urgency, hematuria, bloody urethral discharge, urinary incontinence, urinary retention, pelvic or urethral pain, or a vaginal bulge or mass.
Not all urethral diverticula need to be treated. However, if a woman is symptomatic, surgical excision is the treatment of choice. Often the surgeon will order an MRI of the pelvis to identify the complete extent of the diverticulum and to ensure there are no solid components. The surgery itself usually takes less than an hour and is performed on an outpatient basis. Usually, the patient will need to have a foley catheter in place to drain the urine for about 7-10 days after the procedure. This ensures proper healing and prevents breakdown of the sutures. Risks of the procedure include bleeding, infection, recurrent diverticulum formation, urethro-vaginal fistula, and urethral stricture. However, complications from this procedure are usually very low.