What's the most likely diagnosis?

• Post-void image from VCUG in a 45 year-old female

1. Osteoarthritis of both hips
2. Bladder calculus
3. Urethral diverticulum
4. Stone in a urethral diverticulum
5. Uterine fibroid

Additional image - Scout image from same study

 

Additional Image

Scout image prior to start of voiding cystourethrogram

Answer:

 

3. Urethral diverticulum

 

 

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Urethral Diverticulum

General Considerations

• Much more common in females than males, in whom they are rare
  • Most often in women 30-50 years of age
  • In males, they are believed to be congenital; in females, most are acquired
• Relatively common in women, especially with recurrent genitourinary infections, post-void dribbling and dyspareunia
• Described as an outpouching of tissue from the posterior wall of the urethra (usually) into the urethrovaginal potential space
  • Lining of diverticulum is identical to urethral mucosa
• Most are thought to be derived from dilated paraurethral ducts or glands
  

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