A urethral diverticulum is a condition in which a fluid-filled sac forms on the urethra, the tube that takes urine out of the body. These sacs can become infected and lead to other conditions.
A urethral diverticulum occurs mostly frequently in women but can also occur in men. It is essential to get a urethral diverticulum treated if you have one, as symptoms can be challenging to live with and could pose more severe health implications if left untreated.
What Causes a Urethral Diverticulum?
Urethral diverticulums may be present at birth or develop with time.
Often, urethral diverticulum happens in people who have experienced multiple bladder infections, which may weaken the urethral wall. A block of the glands near the urethra may also lead to a urethral diverticulum.
Delivering a baby vaginally may be a risk factor for developing a urethral diverticulum. This is due to stress the birthing process’s places on muscles and glands around the urethra.
In men, risk factors for urethral diverticulum are:
- Frequent urinary tract infections (UTIs)
- Difficulty fully emptying the bladder
- A condition in which the urethral opening is on the underside of the penis
- Trauma or injury to or around the urethra
What Are the Symptoms of a Urethral Diverticulum?
The severity and appearance of a urethral diverticulum symptoms can vary from person to person. Around 20% of people with urethral diverticulum do not have very distinct symptoms. Some of the most common symptoms for women, though, are:
- Regularly occurring bladder infections or UTIs
- Pain in the pelvis
- Frequent urges to urinate
- Lack of urination after feeling an intense desire to urinate
- Urinating eight or more times per day
- Needing to urinate more than twice a night
- Pain during sex
- Blood in urine
- Irregular vaginal discharge
- Difficulty emptying the entire bladder
- Accidentally urinating
- Burning sensation during urination
For men, symptoms of a urethral diverticulum include:
- Post-urination dribbling
- Difficulty urinating
- A weak stream of urine
- Abnormalities in the size of the penis or scrotum
- Difficulty completely emptying urine from the bladder
- Restriction in the urethra
- Leaking urine from the groin
How Is a Urethral Diverticulum Diagnosed?
A urethral diverticulum isn’t easy to diagnose because its symptoms are common to other conditions, including:
- Interstitial cystitis. This is a chronic bladder condition that results in pain and discomfort in the pelvis. It inflames and irritates the bladder, which can cause scarring in the bladder. Many of the symptoms around urination, pelvic discomfort, and pain are similar to urethral diverticulum.
- Recurrent cystitis. When you have three or more UTIs within a year, this is called recurrent cystitis. It is a severely painful condition, yet not much is known about its risk factors or causes.
- Vulvodynia. This is more of a physical symptom than a condition. It is a burning irritation at the opening of your vagina or your vulva. You can experience it as burning, soreness, stinging, rawness, or extreme pain during sex.
- Endometriosis. If you have this condition, the tissue that usually grows in your uterus starts to grow on, in, and around different parts of your reproductive system. This extra tissue is still connected to your menstrual cycle and swells, even though it is not in the uterus. This movement causes inflammation and scarring in the areas near this tissue.
Usually, an evaluation for urethral diverticulum will include:
- A regular pelvic exam
- Analysis of your urine
- A physical exam of your urethra
- Imaging tests
Some of the imaging tests that may be performed are:
- Voiding cystourethrogram. This test uses minimally invasive X-rays to test how your bladder functions. It will take images of your ureter before and after you empty your bladder.
- Ultrasound. These tests will use sound waves in and around your urethra to create an image of the area.
- MRI. An MRI utilizes both magnetic fields and radio waves to make images of your tissues and organs.
What Is the Treatment for a Urethral Diverticulum?
Symptoms of a urethral diverticulum can disappear or remain the same for long periods. You may not feel them at all.
If the urethral diverticulum is painful, the most common treatment is surgery. Your doctor may remove the sac, or they may drain it through the vagina.
Your doctor will also treat other urinary issues you may have during this surgery. Typically, after surgery, you will have to be on antibiotics for at least a day. You may also need to continue to have a catheter inserted into your bladder for up to three weeks. Usually, you will have a follow-up appointment around this time with your doctor. Depending on your body’s response to your surgery, they may remove the catheter.