Year :
2015
| Month :
October
| Volume :
9
| Issue :
10
| Page :
QD08 - QD09
Full Version
Urethral Diverticulum Masquerading
as Anterior Vaginal Wall Cyst:
A Diagnostic Dilemma
Published: October 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6636
Gurpreet Kaur, Sandhya Jain, Abha Sharma, Amita Suneja, Kiran Guleria
1. Senior Resident, Department of Obstetrics and Gynaecology, Delhi State Cancer Institute (DSCI), Delhi, India.
2. Assistant Professor, Department of Obstetrics and Gynaecology, UCMS and GTB Hospital, Delhi, India.
3. Specialist, Department of Obstetrics and Gynaecology, UCMS and GTB Hospital, Delhi, India.
4. Professor, Department of Obstetrics and Gynaecology, UCMS and GTB Hospital, Delhi, India.
5. Professor, Department of Obstetrics and Gynaecology, UCMS and GTB Hospital, Delhi, India.
Correspondence Address :
Dr. Sandhya Jain,
125, SFS Flats, Phase-4, Ashok Vihar, Delhi-52, India.
E-mail : drsandy2010@rediffmail.com
Abstract
Urethral diverticulum (UD) is a condition in which a variably sized outpouching forms, next to the urethra. Because it connects to the urethra, this outpouching repeatedly gets filled with urine during micturition, thus causing symptoms. In females, it presents as a bulge in anterior vagina, mimicking a vaginal wall cyst. Various aetiologies proposed attributing to urethral diverticulum formation is repeated infection of the periurethral gland, childbirth trauma, iatrogenic and urethral instrumentation. Patients of UD present with non specific irritative lower urinary tract symptoms such as increased frequency, urgency and dysuria; symptoms may not correlate with the size of the diverticulum. Recurrent cystitis or urinary tract infection is seen in one-third of patients. Pain, hematuria, post-void dribbling, dyspareunia, urinary retention or incontinence is other symptoms. In some cases, there may be associated urethral calculi or carcinoma. Magnetic resonance imaging (MRI) is highly sensitive and specific for the diagnosis of UD, although non invasive sonography may be the first line investigation. Treatment is by transvaginal diverticulectomy or marsupialization. A 60-year-old P9L6 postmenopausal lady, presented with a tender, hard suburethral anterior vaginal wall mass. Cystourethroscopy revealed a small opening in posterior urethra, with stone visible through it. With the final diagnosis of suburethral diverticulum with retained multiple calculi, excision of the diverticulum and repair of urethra was done vaginally. Correct evaluation and treatment of this condition can lead to avoidance of urinary tract injury.
Keywords
Calculus, Cystourethroscopy, Vaginal cyst
DOI: 10.7860/JCDR/2015/13187.6636
Date of Submission: Jan 23, 2015
Date of Peer Review: Apr 29, 2015
Date of Acceptance: Aug 03, 2015
Date of Publishing: Oct 01, 2015
Financial OR OTHER COMPETING INTERESTS: None.
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