Contrast-enhanced voiding urosonography (CEVUS) as a novel technique for evaluation in a case of male urethral diverticulum (original) (raw)
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Transvaginal ultrasound for the detection of urethral diverticula at urodynamic assessment
International Urogynecology Journal, 1992
At the time of urodynamic assessment, 91 patients were examined by transvaginal echography. Two urethral diverticula were detected, one of which was only detected by ultrasound. Transvaginal echography clearly showed the size and anatomical relationship of the diverticulum to the bladder. We conclude that the procedure is a useful adjunct to routine testing for the detection of urethral diverticula.
Male urethral diverticulum: the double density sign
Urology, 1985
An anatomic defect of the urethra is occasionally the cause of voiding dysfunction in the young male patient. A urethral diverticulum can often be overlooked if retrograde urethrography is not performed properly. Two cases are presented along with a discussion of the technique for dynamic retrograde urethrography. The description of a new radiologic sign indicative of a posterior bulbar urethral diverticulum, is presented.
Diagnostic tools for female urethral diverticulum: Current perspectives
Urogynaecologia
Although once considered quite a rare condition in the past, female urethral diverticulum (UD) would now appear to have a higher frequency, perhaps due to greater attention from physicians. To date, there is no agreement on which is the best method for diagnosis of female UD. Traditionally, the approach was based on quite invasive techniques, such as voiding cystourethrography, and double-balloon urethrography, with satisfactory results but relevant limitations. More recent high-resolution imaging techniques, such as 2D-3D ultrasonography (US) and magnetic resonance imaging (MRI) have also been applied in the study of the abnormalities of the female urethra. US had the advantage of the outpatient setting, non-invasiveness and absence of contrast medium use; MRI, is characterized by high sensitivity thanks to multiplanar capability, with an optimal characterization of periurethral diseases or its abnormalities, and lack of ionizing radiation. A real innovation is represented by compu...
European radiology, 2003
The preoperative work-up of female urethral diverticula should provide the surgeon with maximum data regarding the anatomy and structure of the diverticulum. Preoperatively, the number of diverticula, as well as the location, size, configuration, and communication to the urethra need to be clearly depicted. The objective of this study was to compare the information gained by voiding cystourethrography (VCUG) and positive-pressure double-balloon urethrography (DBU), and to verify which imaging modality can better delineate the features of the diverticula. Twelve women with a presumptive clinical diagnosis of a urethral diverticulum underwent VCUG followed by DBU, and the radiological data from each modality were compared. In 4 of 12 patients (33.3%) VCUG completely failed in demonstrating the diverticulum, whereas DBU showed a large complex diverticulum in 2 patients and a distinct mid-urethral diverticulum in 2 patients. In the remaining 8 women (66.7%) VCUG delineated only the lowe...
International Urogynecology Journal, 2013
Introduction and hypothesis Our purpose was to assess the accuracy of history and physical, cystourethroscopy, and magnetic resonance imaging (MRI) in preoperative diagnosis of urethral diverticula. Methods This was a retrospective review of all patients who underwent surgical excision of periurethral masses between 1998 and 2009. Presenting symptoms and examination and cystourethroscopic findings were noted. A single pathologist reviewed all cases and provided the reference standard for the diagnosis of a diverticulum. A single radiologist reviewed all preoperative MRI studies. Sensitivities, specificities, and positive and negative predictive values (PPV, NPV) were determined. Results Diverticula were diagnosed in 36/60 (60 %) patients. Transurethral fluid expression on palpation and recurrent urinary tract infection (UTI) had high PPV. Sensitivity, specificity, PPV, and NPV, respectively, for cystourethroscopy were 33 %, 100 %, 100 %, and 42 %; for MRI, these were 100 %, 83 %, 92 %, and 100 %. Conclusion These data reinforce the utility of transurethral fluid expression for preoperative evaluation of urethral diverticula. Additionally, MRI is an excellent adjunctive diagnostic tool and may assist in establishing the diagnosis when there is high clinical suspicion of a urethral diverticulum but nonconfirmatory findings on cystourethroscopy.
A Single-Center Experience of Symptomatic Male Urethral Diverticula
Urology, 2007
To describe our experience of the etiology, presentation, management and outcomes of male urethral diverticula, which are uncommon, with few reports of large series published. METHODS Twenty-one patients with male urethral diverticula were treated at a single institution during a 7-year period. Their case notes were retrospectively reviewed. RESULTS Of the 21 diverticula, 7 (33.3%) were congenital as determined from the history and histologic analysis. These 7 patients' mean age at presentation was 25 years, and they complained mainly of obstructive symptoms, poor bladder emptying, and a palpable perineal swelling. The 14 patients with acquired diverticula presented later, at a mean age of 35 years, but with almost identical symptoms and signs. The most common aetiolgical factors included trauma in 3, urethral stricture disease in 3, and previous urethroplasty in 3. The anterior urethra and penoscrotal junction were the most commonly affected sites in both groups (18 of 21). Overall, 12 patients underwent open surgical repair, 6 underwent endoscopy, and in 3, the diverticulum was left in situ. Postoperative complications were more frequent in the acquired group (64% versus 27%) and included urethrocutaneous fistula in 5, urethral stricture in 2, and wound infection in 4. CONCLUSIONS Urethral diverticula are uncommon, but should always be considered in young men with lower urinary tract symptoms or in those with a history of urethral trauma. Treatment should be individualized and determined according to the patient's fitness and the site and size of the diverticulum. UROLOGY 70: 650-653, 2007.
Acquired male urethral diverticulum: case reports
The Nigerian postgraduate medical journal, 2009
Urethral diverticulum is a localised out pouching or fusiform dilatation of the urethra. It is an uncommon clinical entity affecting both males and females. Although, the diagnosis could be straightforward in the males, it may present as a diagnostic puzzle in the female because it often presents with non-specific symptomatology and diagnosis may not be easily made with common investigation techniques. Two cases of urethral diverticulum are presented to highlight the aetiopathogenesis of urethral diverticulum.