Urethral diverticulum and periurethral cyst: symptoms, diagnostics, treatment and outcome.

Abstract

Objectives. In order to contribute to better diagnostic and treatment, we compared the symptomatology, diagnostics, treatment and outcome in women with a urethral diverticulum or a periurethral cyst. Methods. We performed a retrospective extraction of data from medical records including 70 women with a urethral diverticulum or a periurethral cyst, operated at our department from January 2010 until December 2013. Fischer’s exact test and t-test were used for statistical analyses. Results. In total, 31 women were diagnosed with a diverticulum and 39 with a periurethral cyst.  Women with a diverticulum had significantly more often voiding pain (45 % vs 8 %, p=0.001), urethral/vaginal pain (45% vs 15 %, p=0.01), recurrent urinary tract infection (23 % vs. 5 %, p=0.01), urinary incontinence (45 % vs. 21 %, p=0.04), and urethral discharge (39 % vs. 15 %, p=0.03) compared to women with a periurethral cyst. The only symptom less frequent in the diverticulum group was a bulky feeling (42 % vs. 74 %, p=0.01). In the diverticulum group, 87% had resections and 13% marsupialization, while in the cyst group 59 % had resections and 41 % marsupialization (p=0.02). In the diverticulum group four (13%) experienced recurrence compared to none in the cyst group (p=0.03). Furthermore, one patient referred as a diverticulum had urethral cancer.   Conclusions. Urethral diverticula and periurethral cysts should be considered in women with lower urinary tract symptoms and pain. Urethral diverticula are more complicated to diagnose and to treat. Tweetable abstract: Urethral diverticula and periurethral cysts should be considered in women with lower urinary tract symptoms and pain