If you’re an adult female dealing with frequent urinary tract infections (UTIs), urinary leakage, or pelvic pressure that won’t go away, it may be more than a routine infection. You might have a urethral diverticulum (UD), a small, hidden pouch in the urethral wall that traps urine and causes many uncomfortable symptoms. With today’s improved imaging tests and increased awareness about the condition, urethral diverticulum is more common than once thought.
At Tower Urology, our urogynecology specialists are trained to recognize and treat even the most elusive lower urinary tract symptoms, using state-of-the-art diagnostics and expert surgical treatment options tailored to your needs.
Find some ‘before and after’ urethral diverticulum surgery pictures in this article.
What is a urethral diverticulum?
A urethral diverticulum is an outpouching, or sac-like structure, that forms in the wall of the female urethra, the tube-like structure that carries urine from the bladder to the outside of the body. It typically bulges into the anterior vaginal wall, or the front wall of the vagina. It can collect urine during voiding (peeing) and slowly leak afterward, causing pain, infection, and irritation.
Although historically considered rare, the incidence of female urethral diverticula has increased as more cases are detected through improved imaging techniques, such as magnetic resonance imaging (MRI), voiding cystourethrography, and urethrography. However, many remain undiagnosed due to subtle symptoms that are attributed to other female conditions.
What are common urethral diverticulum symptoms?
Many women have vague or misattributed lower urinary tract symptoms or urethral prolapse, which is why this condition can go overlooked or be misdiagnosed. Common symptoms include:
- Recurrent urinary tract infections (UTIs).
- Dysuria (painful urination).
- Postvoid dribbling or continuous leaking.
- Dyspareunia (pain with intercourse).
- Hematuria (blood in the urine).
- Urinary retention or difficulty starting the flow.
- A vaginal mass or painful bulge along the anterior vaginal wall.
- Stress incontinence or unexpected urine leakage.
The classic symptom trio of dysuria, dyspareunia, and dribbling often strongly suggests a UD, but not every woman experiences all three.
What causes a urethral diverticulum?
While the causes of urethral diverticulum aren’t specifically known, the etiology is generally linked to infection. Multiple bladder infections, potentially weakening the bladder wall, or diseases of the periurethral glands, located on the lower end of the urethra, are often suspected. These glands are responsible for lubrication.
But when these glands become infected, they can swell, form an abscess, and rupture into the urethral wall, creating a diverticular sac. Once this sac forms, it may fill with urine, leading to recurring infections, inflammation, and eventual growth.
Other risk factors include:
- Pelvic trauma or childbirth injuries.
- Use of a catheter.
- Prior endoscopic procedures.
- Hormonal changes.
- Prior urethral stricture or inflammation.
How is it diagnosed?
Diagnosis starts with a thorough physical examination. A trained urologist may feel a tender area or bulge in the vaginal wall. To confirm the diagnosis and map out the diverticulum’s location, we use various methods:
- MRI (magnetic resonance imaging) – highly sensitive and often preferred for assessing size and location.
- Voiding cystourethrogram (VCUG) – shows how urine flows and where it pools.
- Urethrography – a detailed X-ray of the urethra.
- Cystoscopy or urethroscopy – using a tiny camera to examine the urethra for lesions or abnormal openings.
- Urodynamic testing – to assess bladder and urethral function.
Our Tower urogynecology team carefully selects imaging techniques based on your anatomy and symptoms to ensure an accurate, complete picture.
Urethral diverticulum treatment
Most patients need surgical excision to resolve the problem entirely. The standard approach is a urethral diverticulectomy, a reconstructive surgery that involves removing the diverticulum and repairing the urethral and surrounding fascia in layers.
Depending on the case, your surgeon may use a transvaginal (through the vagina) or transurethral (through the urethra) technique. For larger or complex diverticula, we may also use the Martius flap. This procedure involves taking a graft of healthy fat and tissue from the labia to reinforce the repair and reduce complications.
Our surgeons specialize in this delicate procedure, reducing the risk of complications like stress urinary incontinence, urethral stricture, or recurrence. Most women return home the same day with a catheter to help the area heal over 1–2 weeks. Postoperative follow-up is crucial for monitoring healing and preventing long-term issues.
This PDF has more information about the urethral diverticulectomy procedure.
Can it go away on its own?
No, UD can’t go away on its own. Once the pouch forms, it’s there to stay. While symptoms may come and go, the condition requires medical attention to prevent further complications. Delaying treatment can increase the risk of infection and urinary dysfunction. While UD isn’t thought to cause cancer, pouching can be associated with a rare type of cancer called urethral diverticulum carcinoma, a malignancy that typically develops within the pouch itself.
Seeking care can provide symptom relief and help prevent long-term complications. The sooner a urethral diverticulum is appropriately diagnosed and treated, the better the chances for a smooth recovery and lasting improvement in quality of life.
Why turn to Tower Urology for women’s urologic care in Los Angeles?
Urethral diverticulum in women can be complex, frustrating, and often misunderstood. But with the right diagnosis and treatment, relief is possible. At Tower Urology, every woman deserves expert, respectful care delivered with empathy, privacy, and precision.
Our physicians understand the sensitive nature of conditions like recurrent UTIs, pelvic floor dysfunction, and female urethral diverticula. We take the time to truly listen, evaluate all symptoms, and personalize your treatment plan with your comfort and long-term health in mind. From diagnosis to surgical treatment and postoperative follow-up, you’ll be supported every step of the way.
Our approach is personal—we treat patients, not just pathology.
We invite you to establish care with Tower Urology
Tower Urology is a proud affiliate of Cedars-Sinai Medical Center, ranked #1 in California and #2 nationwide by U.S. News & World Report. This partnership reflects our ongoing commitment to providing the highest quality urologic care alongside some of the country’s best urologists and urogynecology specialists.
We are conveniently located to serve patients throughout Southern California, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Burbank, Glendale, and Downtown Los Angeles.
Our services include treatment for pelvic organ prolapse, menopause/hormone management, chronic pelvic pain syndrome in women, shockwave therapy for pelvic pain, interstitial cystitis, lichen sclerosis and planus, urethral diverticulum, urethral stricture disease, urinary fistulas, and vaginal mesh complications.
Urethral Diverticulum FAQs
Urethral diverticulectomy is a urethral diverticulum surgery where the diverticulum is removed and the urethra is rebuilt using reconstructive techniques.
You’ll go home with a catheter for 1–2 weeks and return for follow-up visits. Most women feel relief and improved bladder function after healing.
Sources
Imaging of Female Urethral Diverticulum: An Update
https://pubs.rsna.org/doi/10.1148/rg.287075076
Urethral Diverticula – ScienceDirect
https://www.sciencedirect.com/science/article/abs/pii/S0301211599002109
Diagnosis and Management of Female Urethral Diverticulum
https://pubmed.ncbi.nlm.nih.gov/22453220/
Urethral Diverticulum: A Systematic Review
https://pubmed.ncbi.nlm.nih.gov/31258943/
