Presentation
We report a 3.5-year-old boy who presented with urinary tract infection, rare voiding, and straining during voiding. Ultrasonography and magnetic resonance imaging showed a cystic pelvic mass. [ncbi.nlm.nih.gov]
Features 20 all new case presentations with expert commentary. [books.google.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
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Recurrent Urinary Tract Infection
Urethral diverticula are often overlooked as a source of recurrent urinary tract infection, voiding dysfunction, dyspareunia, and chronic 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]
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]
As mentioned, recurrent urinary tract infection is a frequent complaint in one-third of patients. [femaleurologyaz.blogspot.com]
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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]
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Turkish
J Turkish German Gynecol Assoc. 2006;7:59-61. Hsieh DF, Wu HC. A Ureteral diverticulum mimicking pelvic cyst. JTUA. 2002;13:157-160. Hale NG, Von Geldern CE. Ureteral diverticula. Cal State J Med. 1921;19(7):284-287. PubMed Barrett DM, Malek RS. [urotoday.com]
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Familial Adenomatous Polyposis
Diverticulum of the ureter presenting as an adnexal mass in a woman with familial adenomatous polyposis: A case report. J Turkish German Gynecol Assoc. 2006;7:59-61. Hsieh DF, Wu HC. A Ureteral diverticulum mimicking pelvic cyst. [urotoday.com]
Gastrointestinal
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Left Flank Pain
A drip infusion pyelography (DIP) revealed a pouch with a stone in the left lower ureter. 29 months later, he was re-hospitalized for left flank pain. Urinalysis revealed 10 to 19 RBC and 20-29 WBC/HPF. [ci.nii.ac.jp]
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]
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Abdominal Mass
Typically, it cannot be detected on physical examination unless it is so large as to produce an abdominal mass. It is usually found radiographically on ultrasound. [clinicaladvisor.com]
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Fecal 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]
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Pelvic Mass
Ultrasonography and magnetic resonance imaging showed a cystic pelvic mass. At surgical intervention, however, a massive ureteral cystic structure communicating both with the ureteropelvic and ureterovesical portion of the ureter was observed. [ncbi.nlm.nih.gov]
Musculoskeletal
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Narrow Pelvis
An antegrade pyelography revealed a large cyst with a narrow pelvi-ureteric junction through which the dye did not enter the ureter [Fig. 2]. An angiogram showed a normal right kidney and a smaller pelvi-calyceal system below it. [jpgmonline.com]
Urogenital
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Adnexal Mass
Diverticulum of the ureter presenting as an adnexal mass in a woman with familial adenomatous polyposis: A case report. J Turkish German Gynecol Assoc. 2006;7:59-61. Hsieh DF, Wu HC. A Ureteral diverticulum mimicking pelvic cyst. [urotoday.com]
Treatment
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]
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]
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
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]
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]
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]
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]
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]
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]
It is important to identify the communication site before surgery to completely excise the diverticulum and to prevent recurrence. [urologysurgery.wordpress.com]
This periureteral diverticulum causes vesico-ureteral reflux because it prevents the normal valve mechanism of the distal ureter. [meddean.luc.edu]