title: Incidence of female urethral diverticulum: a population-based analysis and literature review.
abstract: OBJECTIVE
  Urethral diverticulum (UD) is a protrusion of the urethra through the periurethral fascia. We aimed to determine the population-based incidence of female UD.
  
  
  METHODS
  Using the records-linkage system of the Rochester Epidemiology Project (REP), we identified women 18 years and older with a new diagnosis of UD in Olmsted County, Minnesota, USA, from 1 January 1980, through 31 December 2011. We also identified cases meeting the same criteria diagnosed at Mayo Clinic, regardless of county of residency. Incidence rates were calculated and trends for changes in incidence over time were tested. We conducted a systematic search of the MEDLINE, EMBASE, Cochrane Systematic Reviews, CENTRAL, Web of Science, and Scopus databases from inception through 30 March 2013, to identify published reports of UD incidence or prevalence.
  
  
  RESULTS
  We identified 164 incidence cases, including 26 women residing in Olmsted County. Age-adjusted annual incidence of UD in Olmsted County was 17.9 per 1,000,000 women (<0.02 %) per year (95 % CI, 10.9-24.9). We observed a trend toward increased incidence during the past 3 decades (P = 0.03). In our literature review, only 7 studies included an estimate of incidence or prevalence of UD; these estimates ranged from 6.4 per 1,000,000 per year (<0.01 %) having surgical intervention related to UD to a 4.7 % rate of UD diagnosed in asymptomatic women admitted for gynecological or obstetric issues.
  
  
  CONCLUSIONS
  In this population-based study, female UD was a rare disease, affecting fewer than 20 per 1,000,000 women (<0.02 %) per year.
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Sherif A
authors.initials: SA
authors.lastname: El-Nashar
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Bacon
authors.forename: Shunaha
authors.initials: S
authors.lastname: Kim-Fine
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Klingele
mesh_terms: D015331:Cohort Studies; D004240:Diverticulum / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D014522:Urethral Diseases / Q000453:epidemiology*