Abstract: PD26-07
Sources of Funding: None

Introduction

The aetiology of urethral diverticula in women is unknown. Blockage of drainage and subsequent infection of paraurethral glands have been suggested but the primary initiating pathology remains to be elucidated. We have postulated that functional obstruction secondary to a high-tone non-relaxing sphincter may be the primary initiating pathology leading to the formation of a proximal to mid-urethral diverticulum (UD). As urethral pressure profilometry is unreliable in a urethra with a diverticulum, the urethra-sphincter complex volume may be used as a proxy for the maximal urethral closure pressure. _x000D_ We assessed whether urethra-sphincter complex volumes in female patients with proximal to mid-UD are higher than those without.

Methods

The clinical and MRI data of 17 women with a mean age (± SD) of 49.4 years (±13.2 ) with the ostium of the diverticulum at or proximal to 2/3 the length of the urethra were reviewed. A consultant uro-radiologist outlined the urethra-sphincter complex using pelvic axial small field of view T2-weighted MRI sequences with 3 mm slices. OsiriX&[copy] was used to determine the urethra-sphincter complex volume. The findings were compared with a control group consisting of 24 age matched women of mean age 50.8 years (± 11.2 years) having MRI for unrelated conditions._x000D_

Results

The mean urethra-sphincter complex volume for the UD group was 10.01 cm3 (±6.97 cm3). The mean urethra-sphincter volume of the control group was 3.92 cm3 (± 1.60 cm3). This difference was statistically significantly (p = 0.01).

Conclusions

Women with proximal-urethral diverticulum have significantly higher urethra-sphincter complex volumes than those who do not. This finding suggests that high pressure in the proximal urethra during a void secondary to a high-tone non-relaxing sphincter may contribute to the formation of a urethral diverticulum.

Funding

None