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Case of the Week 288

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



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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