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Published in: International Urogynecology Journal 8/2009

01-08-2009 | Original Article

Female urethral diverticulum: a pathological insight

Authors: Matvey Tsivian, Alexander Tsivian, Letizia Shreiber, A. Ami Sidi, Rumelia Koren

Published in: International Urogynecology Journal | Issue 8/2009

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Abstract

Introduction and hypothesis

In this study, we define the histopathological features of female urethral diverticula and attempt to elucidate its pathogenesis and etiology.

Methods

We analyzed 22 clinical records of women diagnosed with urethral diverticula. We collected clinical, surgical, and pathological data. Pathological re-assessment was performed using hematoxylin–eosin and van Gieson stains.

Results

The predominant epithelial types were squamous (41.9%), columnar (31.8%), combined squamous and columnar (18.2%), and cuboidal (13.6%). There was no case of the transitional type. Epithelial ulcerations were present in nine cases. The diverticular wall was composed only of fibrous collagen tissue in all cases. Inflammatory signs were noted in 77.3% of specimens.

Conclusions

Histopathological features of female urethral diverticula match the criteria for paraurethral cysts. Concomitant use of synthetic meshes should be avoided due to the possibility of an infectious etiology. Transvaginal excision of the sac is recommended, while transurethral procedures are contraindicated.
Literature
1.
go back to reference Aldridge CW Jr, Beaton JH, Nanzig RP (1978) A review of office urethroscopy and cystometry. Am J Obstet Gynecol 131:432–437PubMed Aldridge CW Jr, Beaton JH, Nanzig RP (1978) A review of office urethroscopy and cystometry. Am J Obstet Gynecol 131:432–437PubMed
2.
go back to reference Andersen MJ (1967) The incidence of diverticula in the female urethra. J Urol 98:96–98PubMed Andersen MJ (1967) The incidence of diverticula in the female urethra. J Urol 98:96–98PubMed
3.
go back to reference Davis BL, Robinson DG (1970) Diverticula of the female urethra: assay of 120 cases. J Urol 104:850–853PubMed Davis BL, Robinson DG (1970) Diverticula of the female urethra: assay of 120 cases. J Urol 104:850–853PubMed
4.
go back to reference Johnson C (1938) Diverticula and cysts of the female urethra. J Urol 39:506 Johnson C (1938) Diverticula and cysts of the female urethra. J Urol 39:506
5.
go back to reference Young GPH, Wahle GR, Raz S (1996) Female urethral diverticulum. In: Raz S (ed) Female urology, chap 45. W.B. Saunders, Co., Philadelphia, pp 477–489 Young GPH, Wahle GR, Raz S (1996) Female urethral diverticulum. In: Raz S (ed) Female urology, chap 45. W.B. Saunders, Co., Philadelphia, pp 477–489
6.
go back to reference Huffman JW (1948) The detailed anatomy of the para-urethral ducts in the adult human female. Am J Obstet Gynecol 55:86–101PubMed Huffman JW (1948) The detailed anatomy of the para-urethral ducts in the adult human female. Am J Obstet Gynecol 55:86–101PubMed
7.
8.
go back to reference Herbut P (1952) Urological pathology. Lea & Febiger, Philadelphia Herbut P (1952) Urological pathology. Lea & Febiger, Philadelphia
9.
go back to reference Daneshgari F, Zimmern PE, Jacomides L (1999) Magnetic resonance imaging detection of symptomatic noncommunicating intraurethral wall diverticula in women. J Urol 161:1259–261. discussion 61-2PubMedCrossRef Daneshgari F, Zimmern PE, Jacomides L (1999) Magnetic resonance imaging detection of symptomatic noncommunicating intraurethral wall diverticula in women. J Urol 161:1259–261. discussion 61-2PubMedCrossRef
10.
go back to reference Leng WW, McGuire EJ (1998) Management of female urethral diverticula: a new classification. J Urol 160:1297–1300PubMedCrossRef Leng WW, McGuire EJ (1998) Management of female urethral diverticula: a new classification. J Urol 160:1297–1300PubMedCrossRef
11.
go back to reference Brook I (2004) Urinary tract and genito-urinary suppurative infections due to anaerobic bacteria. Int J Urol 11:133–141PubMedCrossRef Brook I (2004) Urinary tract and genito-urinary suppurative infections due to anaerobic bacteria. Int J Urol 11:133–141PubMedCrossRef
12.
go back to reference Sanders CJ, Mulder MM (1998) Periurethral gland abscess: aetiology and treatment. Sex Transm Infect 74:276–278PubMedCrossRef Sanders CJ, Mulder MM (1998) Periurethral gland abscess: aetiology and treatment. Sex Transm Infect 74:276–278PubMedCrossRef
13.
go back to reference Ljungqvist L, Peeker R, Fall M (2007) Female urethral diverticulum: 26-year followup of a large series. J Urol 177:219–224. discussion 24PubMedCrossRef Ljungqvist L, Peeker R, Fall M (2007) Female urethral diverticulum: 26-year followup of a large series. J Urol 177:219–224. discussion 24PubMedCrossRef
14.
go back to reference Hansen BJ, Horby J, Brynitz S, Berg JS (1989) Calculi in female urethral diverticulum. Int Urol Nephrol 21:617–620PubMedCrossRef Hansen BJ, Horby J, Brynitz S, Berg JS (1989) Calculi in female urethral diverticulum. Int Urol Nephrol 21:617–620PubMedCrossRef
16.
go back to reference Hruby G, Choo R, Lehman M, Herschorn S, Kapusta L (2000) Female clear cell adenocarcinoma arising within a urethral diverticulum. Can J Urol 7:1160–1163PubMed Hruby G, Choo R, Lehman M, Herschorn S, Kapusta L (2000) Female clear cell adenocarcinoma arising within a urethral diverticulum. Can J Urol 7:1160–1163PubMed
17.
go back to reference Young D, Bilello S, Gomelsky A (2007) Squamous cell carcinoma in situ in a female urethral diverticulum. South Med J 100:537–539PubMed Young D, Bilello S, Gomelsky A (2007) Squamous cell carcinoma in situ in a female urethral diverticulum. South Med J 100:537–539PubMed
18.
go back to reference Thomas AA, Rackley RR, Lee U, Goldman HB, Vasavada SP, Hansel DE (2008) Urethral diverticula in 90 female patients: a study with emphasis on neoplastic alterations. J Urol 180:2463–2467PubMedCrossRef Thomas AA, Rackley RR, Lee U, Goldman HB, Vasavada SP, Hansel DE (2008) Urethral diverticula in 90 female patients: a study with emphasis on neoplastic alterations. J Urol 180:2463–2467PubMedCrossRef
19.
go back to reference Lapides J (1979) Transurethral treatment of urethral diverticula in women. J Urol 121:736–738PubMed Lapides J (1979) Transurethral treatment of urethral diverticula in women. J Urol 121:736–738PubMed
20.
go back to reference Spencer WF, Streem SB (1987) Diverticulum of the female urethral roof managed endoscopically. J Urol 138:147–148PubMed Spencer WF, Streem SB (1987) Diverticulum of the female urethral roof managed endoscopically. J Urol 138:147–148PubMed
Metadata
Title
Female urethral diverticulum: a pathological insight
Authors
Matvey Tsivian
Alexander Tsivian
Letizia Shreiber
A. Ami Sidi
Rumelia Koren
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 8/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-0874-1

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