Urethral Diverticulectomy

A urethral diverticulum is a saclike protrusion between the tissue surrounding the urethra and the anterior vaginal wall.

Most women diagnosed with urethral diverticulum are between the ages of 30 and 50. Causes of urethral diverticula include an obstructed gland that lies next to the urethra and urethral injury.

Symptoms include painful urination, painful intercourse, dribbling after urination, recurrent urinary tract infections and urinary incontinence. Symptoms may also include bulging in the vagina.

Evaluation consists of a physical exam, detailed history and sometimes an MRI.

Treatment ranges from simple observation to excision by vaginal urethral diverticulectomy. For large or complicated urethral diverticulum, a Martius flap is placed between the urethra and vagina.

During a urethral diverticulectomy, the urethra is first visualized with a scope. Once identified, a small incision is made over the diverticulum and the entire diverticulum sac is removed. In the case of a Martius flap, a fat pad is then brought over from the labia majora to provided additional support to the urethra. The incision is closed and typically heals in 4-6 weeks.