ABSTRACT
To present our experience in the treatment of distal urethral diverticula using a novel surgical transurethral approach. Sixteen women with distal urethral diverticula were studied. Their ages ranged from 26 to 52 years [mean 36 years]. Clinical presentation included chronic intermittent pelvic pain, dysuria, dyspareunia, urgency and post void dribbling of urine. Clinical examination revealed tender anterior vaginal mass or fullness in all cases. Diagnosis of urethral diverticula was based on voiding cystourethrogram [VCUG] and Cystourethrocopy. Patients with proximal, multiple diverticula and those having stress urinary incontinence were excluded from the study. Transurethral diverticulectomy was performed successfully in all cases. The urethral defect was closed transversely with vicryl 3/0 and a Foley's catheter was fixed for two weeks. Follow up VCUG was performed two weeks after surgery to exclude extravasation. The diverticula were posterior in 14 cases and posterolateral in two cases. The average operating time was about 30 minutes. All patients reported subjective relief of pain after surgery. Complications included a urinary tract infection in four patients. One patient had persistent signs of a small, residual diverticulum on VCUG on the 15th day. There were no recurrences or urethrovaginal fistulae. Transurethral diverticulectomy is a simple, safe and effective procedure for treatment of distal urethral diverticula