Urethral diverticulum in the pregnant woman

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Abstract

Urethral diverticulum is a pathological lesion characterized by a sac-shaped protrusion of the urethra. Diverticulum is a rare condition in the urological practice.

Clinical case. The diagnosis, conservative management of diverticulum during pregnancy and surgical treatment on the 7th day after natural childbirth is presented in the article.

A review of similar cases showed that urethral diverticulum in pregnant women should be managed conservatively, using antibiotic therapy, anesthesia, puncture aspiration, and cystoscopic drainage. Diverticulectomy during pregnancy is not recommended, as it is associated with increased anesthetic and surgical risks.

It is necessary to carry out additional training of urologists, obstetricians, gynecologists to improve knowledge about this rare disease.

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About the authors

M. Yu. Gvozdev

Russian University of Medicine; Clinical Hospital named S.I. Spasokukotsky, Department of Health of Moscow

Author for correspondence.
Email: m.gvozdev@mail.ru
ORCID iD: 0000-0001-8684-9336

Ph.D., MD, professor at the Department of Urology of the Russian University of Medicine

Russian Federation, Moscow; Moscow

O. A. Arefieva

Russian University of Medicine; Clinical Hospital named S.I. Spasokukotsky, Department of Health of Moscow

Email: oksadoc@yandex.ru
ORCID iD: 0000-0003-2309-2094
SPIN-code: 3287-8564

Ph.D., senior laboratory assistant at the Department of Urology of the Russian University of Medicine

Russian Federation, Moscow; Moscow

E. K. Lazareva

Russian University of Medicine

Email: christovskaya@rambler.ru
ORCID iD: 0009-0004-0634-088X

resident at the Department of Urology 

Russian Federation, Moscow

A. A. Popov

Moscow Regional Research Institute of Obstetrics and Gynaecology

Email: gyn_endoscopy@mail.ru
ORCID iD: 0000-0003-3692-2421

professor, Ph.D., MD; Head of the Department of Operative Gynecology with Gynecological Oncology with a day hospital 

Russian Federation, Moscow

A. A. Fedorov

Moscow Regional Research Institute of Obstetrics and Gynaecology

Email: aa.fedorov@mail.ru
ORCID iD: 0000-0003-2590-5087

professor, Ph.D., leading researcher 

Russian Federation, Moscow

References

  1. EAU Guidelines 2023 Management of Non-Neurogenic Female Lower Urinary Tract Symptoms. ISBN 978-94-92671-19-6.
  2. Artis K., Sivanesan K., Veerasingham M. A persistent urethral diverticulum in pregnancy: Case report and review of the literature. Case Rep Womens Health. 2020;26:e00189. https://doi.org/10.1016/j.crwh.2020.e00189
  3. Magann E.F., Newton L.S., Barr S.A. Urethral Diverticulum Presenting as a Large Vaginal Mass Complicating Pregnancy and Delivery. Am J Case Rep. 2017;18:1095–1098. https://doi.org/10.12659/ajcr.905578
  4. Xie, Qiao-Xuan & Lo, Tsia Shu & Wu, Pei-Ying & Pue, Leng & Karim, Nazura. Urethral Diverticulum in Pregnancy. Gynecology and Minimally Invasive Therapy. 2015. http://dx.doi.org/10.1016/j.gmit.2015.01.005
  5. Moran P.A., Carey M.P., Dwyer P.L. Urethral diverticula in pregnancy. Aus New Zeal J Obstet Gynaecol. 1998;38(1):102–106. https://doi.org/10.1111/j.1479-828x.1998.tb02972.x
  6. Carswell F.M. Urethral diverticulum in pregnancy: a case report. Int Urogynecol J. 2019;30(12):2149–2151. doi: 10.1007/s00192-019-03890-4.

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. MR tomograms at 26 weeks of pregnancy (A - axial slice, B - frontal slice). Presence of urethral diverticulum (highlighted with a red arrow)

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3. Fig. 2. Gynecologic chair examination. Prolapse of the anterior vaginal wall, urethral diverticulum with traces of multiple punctures

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4. Fig. 3. Urethroscopy. Extraction of contents from the mouth of the diverticulum

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5. Fig. 4. Macro preparation: dissected urethral diverticulum

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