title: Urethral Diverticulum in Women: Retrospective Case Series.
abstract: OBJECTIVE
  We present the management of 17 cases of urethral diverticulum in our department. We describe the various clinical presentations of urethral diverticulum, which may mimic other pelvic floor disorders and result in diagnostic delay.
  
  
  METHODS
  We reviewed 17 cases of urethral diverticulum presented to the urogynaecology department between January 2006 and February 2011 retrospectively. Patient demographics, history, clinical evaluation, diagnostic modalities, and management plans were reviewed. All of them underwent Magnetic Resonance Imaging (MRI) prior to the procedure.
  
  
  RESULTS
  The mean time from onset of symptoms to diagnosis of a urethral diverticulum was 24 ± 5.6 months. MRI identified the urethral diverticulum in all cases while voiding cystourethrography confirmed the diagnosis in 4 (23.5 %). They have been divided into two groups: Group A, (4-6 mm largest axis range) 5 (29.41 %) cases; Group B, (6-33 mm largest axis range) 12(70.59 %). All in Group A were symptomatic with recurrent Urinary Tract Infection (UTI), whereas only 8 (66.6 %) in Group B were symptomatic. Transvaginal diverticulectomy was done in 12 women who were symptomatic (70.5 %). Postoperative evaluation revealed complete resolution of symptoms, such as recurrent UTI, dysuria, and dyspareunia. One patient was unsure of surgery, while conservative approach was opted for asymptomatic patients 4 (23.5 %). The use of preoperative MRI altered the management in 2 (11.7 %) women.
  
  
  CONCLUSIONS
  The diagnosis of urethral diverticulum should be considered in women with recurrent UTI, dysuria, dyspareunia, and irritative voiding symptoms not responding to conservative therapy.
authors.affiliation: Obstetrics & Gynaecology, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK.
authors.forename: Angamuthu S
authors.initials: AS
authors.lastname: Arunkalaivanan
authors.affiliation: Urogynaecology, City Hospital, Dudley Road, Birmingham, B18 7QH UK.
authors.forename: Monica
authors.initials: M
authors.lastname: Baptiste
authors.affiliation: Urology, City Hospital, Dudley Road, Birmingham, B18 7QH UK.
authors.forename: Tariq
authors.initials: T
authors.lastname: Sami
keywords: Diagnosis; Magnetic resonance imaging; Urethral diverticulum; Women