Atypical presentation of recurrent female urethral diverticulum: A case report

INTRODUCTION AND IMPORTANCE: The atypical urethral mucosal outpouching into adjacent tissue is termed urethral diverticulum (UD). Most patients present with a post-void dribble, dyspareunia, and dysuria. CASE PRESENTATION: We reported a 60 years old woman who presented with recurrent urethral discharge, and a palpable lump in the vagina. Cystoscopy showed the location of the diverticular ostium. CLINICAL DISCUSSION: Urethral diverticulum (UD) is uncommon and requires a relatively high level of suspicion, particularly in women with symptoms of atypical voiding. The widely-known classic symptoms involve the ‘three Ds’: post-void dribbling, dyspareunia, and dysuria. For radiological modalities, the transvaginal and transperineal ultrasound (US), Voiding cystourethrogram (VCUG), and cystoscopic examinations should be conducted to establish the diagnosis. CONCLUSION: Urethral Diverticulum (UD) should always be considered in cases of urethral discharge and intravaginal mass. A complete history, complete clinical, VCUG, and cystoscopic examinations should be conducted to establish the diagnosis. The technique of three-layer vaginal flap is related to a very good success rate without major complications.