Use of trans-labial ultrasound in the diagnosis of female urethral diverticula: A diagnostic option to be strongly considered

Abstract

Aim: To demonstrate effectiveness of trans-labial ultrasound (TL-US) in the evaluation of female urethral diverticula (UD).

Methods: In the study period, 20 UD were diagnosed and treated. All data on demographic characteristics, presenting symptoms, physical examination findings, diagnostic and operative procedures, were considered. Patients were referred to TL-US for diverticular evaluation, using a 2D 7.5-MHz endfire probe. For each UD, size, complexity, echogenicity content, and presence of diverticular neck were considered. Follow-up controls were carried out at 1, 6 and 12 months after surgery, to evaluate outcome and need for further intervention.

Results: Mean patient age was 46 years (range, 35-55 years) and mean parity was 1 (range, 0-3). The principal symptoms associated with the diverticular mass was dysuria (25%). In all evaluated cases, UD was single (simple in 15 cases and complex in 5). The mean size of the diverticula was 28 mm (range, 8-50 mm). Nineteen diverticula were diagnosed on TL-US, and urethrocystoscopy was carried out for confirmation. Treatment consisted of diverticulectomy. At 1-, 6- and 12-month follow up after surgery, TL-US showed no recurrence of UD in any of the patients.

Conclusions: TL-US is a valid, mini-invasive and reproducible method to diagnose UD.

Keywords: sonographic diagnosis; trans-labial ultrasound; ultrasound; urethral diverticulum; urethral pathology.