Presentation
Features 20 all new case presentations with expert commentary. [books.google.com]
Children usually present with difficulty in micturition, followed by dribbling of urine. Diverticulum needs treatment to alleviate symptoms and to preserve renal function. [jiaps.com]
Herein we present a case with a view of surgical treatment and long-term results. CASE REPORT A 36-year-old woman, with no significant medical history, presented for chronic right lumbar pain. Her physical examination was unremarkable. [urotoday.com]
Entire Body System
- Pain
Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. [books.google.com]
Inflammation of a diverticulum or of diverticula in the intestinal tract,causing fecal stagnation and pain. 憩室炎憩室炎或肠道憩室炎,引起粪便积滞和疼痛 [hujiang.com]
Patients with bladder injuries may have symptoms such as hematuria (blood in urine), painful or difficulty in urination, and lower abdominal pain. [newcastleurology.com.au]
Do no drive if you are still on narcotic pain medication or have limited mobility. Your return to work will be dependent on your job requirements. Medications Take antibiotics as per prescription. Use prescription pain medication as needed. [metrovanurology.com]
I had no pain at all during intercourse, but immediately after my pain level was an 8 on a scale of 1 -10. [medhelp.org]
- Recurrent Urinary Tract Infection
Urethral diverticula present in myriad ways—most often, as recurrent urinary tract infection, overactive bladder, stress urinary incontinence, and pelvic pain. [mdedge.com]
[…] presented with a three year history of progressive urinary symptoms consisting of dysuria, urinary frequency, recurrent urinary tract infections as well as dyspareunia. [asir-journal.biomedcentral.com]
Other symptoms may include recurrent urinary tract infections, complaint of a vaginal mass, hematuria (blood in the urine), vaginal discharge, obstructive urinary symptoms or urinary incontinence. Some patients may not have any symptoms at all. [urology.ucla.edu]
As mentioned, recurrent urinary tract infection is a frequent complaint in one-third of patients. [femaleurologyaz.blogspot.com]
Signs and Symptoms of Urethral Diverticula Urinary frequency, dysuria Obstructive symptoms: weak urinary stream Recurrent urinary tract infection Dribbling Palpable vaginal mass Complications: abscess, stone formation, carcinoma of the diverticulum (rare [urology-textbook.com]
- Inflammation
Inflammation of a diverticulum or of diverticula in the intestinal tract,causing fecal stagnation and pain. 憩室炎憩室炎或肠道憩室炎,引起粪便积滞和疼痛 [hujiang.com]
Squamous metaplasia of the trigone can be associated with chronic inflammation of the urethrovesical junction 5, 6 which may account for irritative voiding symptoms. [glowm.com]
At histologic examination, a urethral diverticulum demonstrates marked inflammation of the transitional epithelial mucosa, which overlies a thinned circumferential diverticular wall. [radiopaedia.org]
Inflammation of the glands adjacent to the urethra have also been cited as a cause. How is a urethral diverticulum diagnosed? A complete evaluation includes a pelvic examination, urinalysis, cystoscopy and imaging. [urology.ucla.edu]
- Recurrent Infection
Ureteroureteral reflux due to asynchronous peristaltic activity is presumed to be responsible for functional obstruction and recurrent infection. Surgical intervention offered cure. Relevant literature is reviewed Article / Publication Details [karger.com]
If associated with reflux, recurrent infection, or obstruction, they should be resected. However, because of the risk of the development of carcinoma, some surgeons advocate prophylactic surgery in all cases. [radiopaedia.org]
When associated with bladder tumors, recurrent infection, or urinary retention, bladder diverticula will need treatment. [urologyaustin.com]
Recurrent infections and closures of the diverticula ostium leads to an enlargement of the diverticula within the endopelvic and periurethral fascia. The size of the diverticulum may vary between few millimeters to several centimeters. [urology-textbook.com]
They are thought to be derived from the periurethral glands as a result of recurrent infections. Urethral diverticula (UD) have historically been described with the classic triad of three D's e.g. [ncbi.nlm.nih.gov]
- Pathologist
Finding the presence of a smooth muscle layer, the pathologist confirmed this to be a true diverticulum. [ncbi.nlm.nih.gov]
The excised diverticulum is then sent to the pathologist for evaluation, and a catheter is left in place for several days to ensure healing. Advantages of Robotic Bladder Diverticulectomy Less post-operative discomfort and scarring. [med.nyu.edu]
Neurologic
- Irritability
Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. [books.google.com]
Jordan が「過敏性大腸 irritable colon」として報告した。 Henry Bockus (1894〜1982,元ペンシルバニア大学消化器科教授)の消化器病学の教科書でirritable colonが大々的に取り上げられた。 [shiga-med.ac.jp]
Squamous metaplasia of the trigone can be associated with chronic inflammation of the urethrovesical junction 5, 6 which may account for irritative voiding symptoms. [glowm.com]
Some other common symptoms include: irritative urinary symptoms such as frequency and urgency. Dyspareunia is noted in 12-24% of patients, and 5-32% of patients will complain of post-void dribbling. [femaleurologyaz.blogspot.com]
Repeated infection and irritation predispose to malignant transformation of the lining urothelium 4. Urethral diverticula usually communicate with the urethral lumen and protrude through and stretch the periurethral smooth muscle. [radiopaedia.org]
Urogenital
- Incontinence
Edited and authored by some of the most respected figures in the field, this newly revised book is your comprehensive guide to all areas of urogynecology, including urinary and fecal incontinence, urodynamic testing, management of genuine stress incontinence [books.google.com]
Of the women 36 (61.9%) had urinary incontinence as a presenting symptom and 20 (31.7%) had incontinence as the only presenting complaint. [scienceopen.com]
[…] any leakage across the bladder neck) from genuine stress urinary incontinence (GSUI). [urologysurgery.wordpress.com]
(B) Funneling of the urethrovesicular junction with Valsalva in a woman with stress urinary incontinence. [glowm.com]
- Dysuria
[…] presented with a three year history of progressive urinary symptoms consisting of dysuria, urinary frequency, recurrent urinary tract infections as well as dyspareunia. [asir-journal.biomedcentral.com]
During these episodes she has fever, nausea, dysuria (painful urination) and left flank pain. Her renal and bladder ultrasound shows two normal kidneys. You order this voiding cystourethrogram. [meddean.luc.edu]
The classic symptoms of a urethral diverticulum are post-void dribbling, dyspareunia (pain with intercourse), and dysuria (pain with urination). Symptoms, however, vary widely depending on the location and size of the diverticulum. [med.unc.edu]
Midurethral sling erosion (black arrow) into the urethra in a woman with urinary urgency, urinary frequency, and dysuria. [glowm.com]
Symptoms may include dysuria (burning with urination), dyspareunia (painful intercourse),, and dribbling after voiding. [urology.ucla.edu]
- Dyspareunia
Recurring dyspareunia was reported at follow-up examinations. [asir-journal.biomedcentral.com]
Dyspareunia is noted in 12-24% of patients, and 5-32% of patients will complain of post-void dribbling. As mentioned, recurrent urinary tract infection is a frequent complaint in one-third of patients. [femaleurologyaz.blogspot.com]
The classic symptoms of a urethral diverticulum are post-void dribbling, dyspareunia (pain with intercourse), and dysuria (pain with urination). Symptoms, however, vary widely depending on the location and size of the diverticulum. [med.unc.edu]
Symptoms may include dysuria (burning with urination), dyspareunia (painful intercourse),, and dribbling after voiding. [urology.ucla.edu]
Urethral diverticula are often overlooked as a source of recurrent urinary tract infection, voiding dysfunction, dyspareunia, and chronic pelvic pain. [mdedge.com]
- Pelvic Pain
Urethral diverticula are often overlooked as a source of recurrent urinary tract infection, voiding dysfunction, dyspareunia, and chronic pelvic pain. [mdedge.com]
It is can cause: A painful vaginal mass Ongoing pelvic pain Many urinary tract infections (UTI) It is rare, but more common in women between age 40 and 70. Children are not usually affected, unless they've had urethral surgery. [urologyhealth.org]
Most patients had been treated for cystitis, bladder overactivity ,incontinence, interstitial cystitis and pelvic pain syndrom e before the correct diagnosis is made. [jeremyockrim.co.uk]
They can be asymptomatic and incidentally detected or may present with symptoms like painful vaginal mass, chronic pelvic pain, refractory lower urinary tract symptoms, and recurrent urinary tract infections (UTI).[ 1 ] Because of the varied symptomatology [ncbi.nlm.nih.gov]
[…] or suprapubic pain, perineal pain, pelvic pressure, urinary hesitancy, purulent urethral discharge, feeling of incomplete emptying, urinary retention, and isolated terminal dysuria. [emedicine.medscape.com]
- Cloudy Urine
All UD contained cloudy urine. Histologic examination revealed UD wall structure identical to the ureter structure with signs of inflammatory infiltration. According to Delmas and Delmas [ 10 ] UD are often discovered incidentally. [radiologykey.com]
Treatment
Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. [books.google.com]
When diagnosed, treatment of the diverticulum depends on the clinical presentations [2]. Treatment is indicated if the diverticulum is thought to be the cause of symptoms or if complications ensue. [urotoday.com]
Treatment consisted of excision of the diverticulum and repair of the narrowed area in the ureter. At 4-year followup there was no deterioration on excretory urography and renal function tests have remained normal. [ncbi.nlm.nih.gov]
Bladder diverticula require treatment only if they are symptomatic. [clinicaladvisor.com]
Prognosis
Treatment and prognosis There is no specific treatment indicated in asymptomatic patients. [radiopaedia.org]
[…] surgically If they cause obstruction, there are recurrent UTI, reflux or stone formation Complications Infection Stones Epithelial dysplasia Vesicoureteral reflux (more common) Ureteral obstruction (very rare) Bladder outlet obstruction (very rare) Prognosis [learningradiology.com]
Schade ROK, Swinny J: The association of urothelial atypism with neoplasia: its importance in treatment and prognosis. J Urol 109 :619–622, 1973 PubMed Google Scholar 13. [link.springer.com]
Etiology
Evaluation Lab tests: PSA in men, electrolytes, and kidney function Urine tests: urinalysis, urine culture and sensitivity, possible urine cytology if concern for a malignant etiology Imaging: Depending on concern for different etiologies (plain film [nuomed.com]
In addition, issues relating to terminology, classification, statistics, etiology, pathogenesis, clinical presentation and differential diagnosis are discussed. [books.google.de]
Its etiology remains unknown, although many theories have been proposed. It may be congenital or acquired [2]. Congenital diverticula of the ureter are exceptional and only a few cases were reported in the literature. [urotoday.com]
The etiology and clinical significance of ureteral pseudodiverticulosis are not clear, but chronic inflammation and/or obstruction are likely causes. [radiopaedia.org]
Definition / general Outpouchings of urothelial mucosa through bladder muscular wall Sites Most diverticula are solitary lesions located in lateral walls of bladder Etiology Congenital cases are due to bladder outlet obstruction or failure of muscle development [pathologyoutlines.com]
Epidemiology
Epidemiology Women, 30–70 years old. Etiology of Female Urethral Diverticula Aquired Diverticula of the Female Urethra Most commonly, diverticula of the female urethra arise from infected periurethral glands. [urology-textbook.com]
Journal Journal ID (nlm-ta): Pan Afr Med J Journal ID (iso-abbrev): Pan Afr Med J Journal ID (publisher-id): PAMJ Title: The Pan African Medical Journal Publisher: The African Field Epidemiology Network ISSN (Electronic): 1937-8688 Publication date (Electronic [scienceopen.com]
Horseshoe-shaped diverticula and diverticula that completely surround the urethra are both associated with worse outcomes, as are those located close to the bladder, and large (over 3–4 cm) diverticula. [3] Epidemiology [ edit ] The incidence of urethral [en.wikipedia.org]
Epidemiology Frequency The frequency with which this disorder occurs is difficult to estimate due to the high probability of a substantial number of missed or misdiagnosed cases in any given population. [emedicine.medscape.com]
Pathophysiology
CrossRef PubMed Google Scholar Koff, S.A. (1990) Pathophysiology of ureteropelvic junction obstructions. Urol. Clin. North. Am. 17, 263–272. [link.springer.com]
Pathophysiology The pathophysiology of most cases of urethral diverticula appears to revolve around obstruction of and infection within the paraurethral glands. [emedicine.medscape.com]
Prevention
The fact that fenoterol (which was used for the prevention of preterm labor in the boy's mother) significantly decreases frequency and amplitude of upper urinary tract contractions suggests that fenoterol treatment might have influenced the occurrence [ncbi.nlm.nih.gov]
It is very important that the whole lining of the urethral diverticulum is removed to prevent recurrence and to ensure that the neck of diverticulum is closed in such a way to prevent postoperative urethrovaginal fistula formation. [jeremyockrim.co.uk]
This periureteral diverticulum causes vesico-ureteral reflux because it prevents the normal valve mechanism of the distal ureter. [meddean.luc.edu]
It is important to identify the communication site before surgery to completely excise the diverticulum and to prevent recurrence. [urologysurgery.wordpress.com]