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• W2010003622 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 1999DOUBLE BALLOON POSITIVE PRESSURE URETHROGRAPHY IS A MORE SENSITIVE TEST THAN VOIDING CYSTOURETHROGRAPHY FOR DIAGNOSING URETHRAL DIVERTICULUM IN WOMEN KARNY JACOBY and RONALD K. ROWBOTHAM KARNY JACOBYKARNY JACOBY More articles by this author and RONALD K. ROWBOTHAMRONALD K. ROWBOTHAM More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68102-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the relative sensitivity of double balloon positive pressure urethrography and voiding cystourethrography for diagnosing urethral diverticula in women, and for evaluating which presenting symptoms should be considered clinically suspicious for even smaller diverticula. Materials and Methods: The series comprised 32 women, including those with new onset urinary tract infections not related to intercourse, menopause or catheters, those with urethral symptoms, such as point urethral tenderness or a mass, urethral pain, dysuria, dyspareunia or post-void dribbling, and those with new onset urgency and frequency. All patients underwent a history and physical examination by the same physician. Each patient underwent double balloon urethrography and voiding cystourethrography on the same day at a single radiology department. Results: Of the 32 women 30 (94%) were diagnosed with at least 1 diverticulum by double balloon urethrography. In 22 of these cases voiding cystourethrography failed to show the diverticulum. Only 11 of these patients (37%) had a palpable mass on clinical examination. The most common presenting symptoms in patients diagnosed with a diverticulum were recurrent urinary tract infection (52%), dysuria (52%), urgency (41%), frequency (38%), stress incontinence (38%) and urge incontinence (34%). Only 3 patients (9%) presented with 1 symptom. Diverticulectomy was performed in 16 patients. Double balloon urethrography had greater sensitivity (100%) than voiding cystourethrography (44%) relative to a confirmed surgical diagnosis (z test p = 0.002). Of 9 diverticula missed by voiding cystourethrography in the surgery group the maximum diameter was less than 15 mm. in 5. Average followup in the surgery cases is 34 months (median 35, range 17 to 50). None of these patients has had new symptoms suggestive of recurrent diverticulum, failure, new urethritis or new stress urinary incontinence. Conservative therapy consisted of long-term antibiotics in 6 patients and symptomatic treatment with short-term antibiotics in the remaining 8. Conservative therapy offered symptomatic relief in most cases but did not prevent recurrent symptoms. Conclusions: A diverticulum should be suspected in patients with new onset urinary tract infection, urgency and frequency as well as dyspareunia, post-void dribbling and dysuria. Double balloon urethrography is a more sensitive diagnostic test than voiding cystourethrography for diagnosing urethral diverticula. Patients with mild symptoms may be treated with conservative therapy, although we believe that satisfactory long-term treatment of diverticula is best achieved by surgical excision. References 1 : Surgical treatment of female urethral diverticulum. Sem. Urol.1986; 4: 33. Google Scholar 2 : Diverticula of female urethra: assay of 120 cases. Sem. Urol.1970; 104: 850. Abstract, Google Scholar 3 : Positive pressure urethroscopy: a new diagnostic method. J. Urol.1956; 75: 753. Google Scholar 4 : The role of voiding cystourethroscopy in the evaluation of the female lower urinary tract. Probl. Urol.1991; 5: 23. Google Scholar 5 : Atlas of Transvaginal Surgery. Philadelphia: W. B. Saunders1992. Google Scholar 6 : Surgical treatment of concomitant urethral diverticulum and stress incontinence. Urol. Clin. N. Amer.1991; 18: 365. Google Scholar 7 : Experience with the management of urethral diverticulum in 63 women. J. Urol.1994; 152: 1445. Link, Google Scholar 8 : Role of urodynamics in management of urethral diverticulum in females. Urology1986; 28: 342. Google Scholar From Northwest Hospital, Seattle, Washington© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by (2018) EDITORIAL COMMENTJournal of Urology, VOL. 164, NO. 2, (433-433), Online publication date: 1-Aug-2000. Volume 162Issue 6December 1999Page: 2066-2069 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.Keywordsurethradiverticulumsensitivity and specificityMetricsAuthor Information KARNY JACOBY More articles by this author RONALD K. ROWBOTHAM More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2010003622 title "DOUBLE BALLOON POSITIVE PRESSURE URETHROGRAPHY IS A MORE SENSITIVE TEST THAN VOIDING CYSTOURETHROGRAPHY FOR DIAGNOSING URETHRAL DIVERTICULUM IN WOMEN" @default.
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• W2010003622 doi "https://doi.org/10.1016/s0022-5347(05)68102-5" @default.
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