Sonography of the female urethra.
OBJECTIVE
The purpose of this study was to explore the role of sonography for women with urethral symptoms and a suspected urethral diverticulum.


METHODS
Nineteen women with urethral symptoms underwent voiding cystourethrography (VCUG) and transvaginal, transperineal, and urethral sonography (using a catheter-based transducer). VCUGs and sonograms were evaluated for diverticula, defined on sonography by direct visualization of the neck connecting the periurethral sac with the urethral lumen. The diverticular neck, size, location, and shape were noted. Lesions revealed by sonography as not connected to the urethra were also noted.


RESULTS
Of 19 women, 14 had urethral diverticula and one had two diverticula, for a total of 15 diverticula. On sonography the diverticula ranged in diameter from 2 mm to 5 cm. Both sonography and VCUG showed 13 of the 15 diverticula. In addition, sonography revealed two infected periurethral cysts, a periurethral leiomyoma, a diffuse urethritis, and scarring or deformity of one patient's urethra from a prior diverticulectomy. On sonography, eight of the 13 diverticula wrapped around more than 50% of the urethral circumference. The neck was precisely seen (by definition) in 13 of 15 diverticula on sonography and in two of 13 diverticula on VCUG.


CONCLUSIONS
Sonography is useful in this group of women with urethral symptoms and suspected urethral diverticula. It provides information on the extent and location of the diverticular neck, both of which are important in surgical excision. Also, sonography provides information on lesions not connected to the urethra. Sonography may prove useful in a broader group of women with urethral symptomatology.
Siegel
C L
CL
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Middleton
W D
WD
Teefey
S A
SA
Wainstein
M A
MA
McDougall
E M
EM
Klutke
C G
CG
D000328:Adult; D002404:Catheterization / Q000295:instrumentation; D002921:Cicatrix / Q000000981:diagnostic imaging; D003287:Contrast Media; D003560:Cysts / Q000000981:diagnostic imaging; D004240:Diverticulum / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine; D007889:Leiomyoma / Q000000981:diagnostic imaging; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D014159:Transducers; D018615:Ultrasonography, Doppler, Color; D014521:Urethra / Q000000981:diagnostic imaging; D014522:Urethral Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D014523:Urethral Neoplasms / Q000000981:diagnostic imaging; D014526:Urethritis / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging
D003287:Contrast Media; D007482:Iothalamate Meglumine