Do you often get urinary tract infections? Do you feel like you have to urinate again after you finish urinating? Or do you experience pain during sex? Many women spend their time in discomfort with such problems. Sometimes the reason for this can be something different than we think. Today we are going to talk about such a condition, which is not so well known but can affect women. That is Urethral Diverticulum.
Simply put, what is Urethral Diverticulum (UD)?
To understand this, let's first take a look at how our urinary system works. Urine, which collects in our bladder, leaves the body through a small tube called the urethra . In women, this urethra is very short, about 4 centimeters long.
Now imagine that in this tube where urine goes, that is, the urethra, something like a small pouch or a lump forms along the wall. It bulges out like a balloon. That's what we call a Urethral Diverticulum (UD) . This is an unnecessary pouch that forms.
Since this bag is located right in the urinary tract, urine can fill it when you urinate. Sometimes, it can even become filled with germs and pus. This can lead to frequent infections and many other problems, such as pain.
Is this a situation that happens to many people?
Not really. This is a rare condition. But the number of people who are diagnosed with this condition is a little higher now than before. The reason for this is that advanced medical technology is now available. Especially with scanning methods like MRI and Ultrasound, it has become possible to detect these kinds of problems inside the body very clearly.
However, because it is rare, sometimes even if there are symptoms, doctors may not pay attention to this aspect. Therefore, some patients may not be accurately diagnosed. This condition is usually seen most often among women between the ages of 30 and 60 .
What causes this?
It's not always easy to find a definitive cause for this, but there are a few things that doctors believe are possible:
- Frequent urinary tract infections: When you have frequent bladder and urethral infections, the wall of the urethra can become weak. This weakness is where the pouch-like part begins to form.
- Blockage of the glands surrounding the urethra: When the openings of the small glands surrounding the urethra become blocked, secretions can accumulate inside them, become infected, and over time, this type of sac can form.
- Congenital problem: Very rarely, this condition can also be caused by a weakness present at birth.
- Impact during childbirth: There is a small chance that this condition may occur due to some pressure or damage to the area during childbirth.
Do you also have these symptoms?
Many women with a urethral diverticulum may feel some discomfort, heaviness, or a lump in the vaginal area. However, one or more of the following symptoms may also occur. Let's look at these to understand them clearly.
| Symptom | A simple explanation |
|---|---|
| Frequent urinary tract infections | Because urine stays inside that bag, germs can easily spread and infections can occur even once or twice a month. |
| Dribbling (urinary leakage) even after urinating | After you finish urinating, the urine that was filled in the bag will come out little by little. This can wet your underwear. |
| Pain during urination | You may feel a burning or pain when urinating, especially if you have an infection. |
| Urgency | You suddenly and uncontrollably need to urinate. You also need to urinate many times a day. |
| Blood in the urine | Sometimes urine can turn pink or red. |
| Pain during sex | Because of the location of this sac, squeezing it during sex can cause severe pain. |
The important thing is that these symptoms are not always the same. Some days they may be mild, some days they may be severe. Also, about 20% of women with this condition may not experience any symptoms at all.
How does a doctor diagnose this condition?
Usually, a doctor suspects this when you tell them about your symptoms, or during a pelvic exam. After that, they run a few tests to find the exact cause.
1. Physical Exam
First, the doctor will examine the walls of your vagina to see if there are any lumps or sacs. They will also try to pinpoint the exact location of the pain. If they feel a sac-like mass, they will gently squeeze it to see if urine or pus comes out. They will also perform a urine analysis to check for infection.
2. Scans and other tests
If suspicion arises after a physical examination, advanced tests like these can be used to confirm it.
- MRI scan (Magnetic Resonance Imaging): This is a method that uses a magnetic field and radio waves to produce very clear pictures of the inside of the body, without using X-rays. This can examine your vagina and the area around your urethra to see if you have a cyst and how big it is.
- Ultrasound Scan: This involves sending high-frequency sound waves into the body and using the echoes to create images of the internal organs. Similar to the scans used to check for a baby during pregnancy, this can also check for lumps or swelling around the urethra.
- Cystoscopy: This involves passing a thin tube with a small camera attached down the urethra to examine the inside of the urethra and bladder. This allows you to see exactly where the opening is. Most of the time, this test can be done in the doctor's office.
What are the treatments for this?
The best and most permanent treatment for a urethral diverticulum is to remove the pouch through surgery .
However, not everyone needs surgery right away. Some women, especially if their symptoms are not too severe, prefer to wait and see. They wait to see if the cyst gets bigger or if their symptoms get worse. However, if you decide to do so, it is important to see your doctor at the appropriate time to monitor your condition.
How the surgery is performed
This surgery is usually performed by a urologist, a doctor who specializes in the urinary system. Because this is a very delicate area, the surgery must be performed without causing any damage to the urethra.
During surgery, the doctor considers many factors, such as the size of the sac and its location, and then chooses one of the following methods.
1. Complete removal of the sac: This is the most common method. An incision is made through the vagina, the sac is completely cut out and removed, and the urethra is repaired.
2. Opening and emptying the sac: In some cases, the neck of the sac is cut, the contents are emptied, and the sac is repaired so that it does not form again.
3. Opening to the vagina: Another method is to create a permanent opening from the pouch to the vagina. Then, the contents that collect inside it will always exit through the vagina.
The good thing is that if you have other problems, such as urinary incontinence, during this surgery, the doctor can sometimes fix that too.
After the surgery
After the surgery, you will need to take antibiotics for about a day. Also, a catheter will be placed in your bladder to help you pass urine easily until the surgery site heals. This will usually be left in place for about two to three weeks. After that time, the doctor will do another exam to see if the wound has healed and then remove the catheter.
What will the situation be like in the future?
Most people recover completely after surgery. However, very rarely, some people may experience complications. For example, if the cyst is not completely removed, problems may arise again. If that happens, you may need to have a second surgery. However, with proper diagnosis and treatment by a qualified doctor, this condition can be completely cured.
Take-Home Message
- A urethral diverticulum is an unwanted pouch that forms along the urethra. It can fill with urine or pus.
- The main symptoms include frequent urinary tract infections, urine leakage after urination, pain during urination, and pain during sexual intercourse.
- Some people may not experience any symptoms.
- If you continue to have symptoms like these, don't be shy or embarrassed, and definitely see your doctor.
- This condition can be accurately diagnosed through tests such as a physical examination, MRI, Ultrasound, and Cystoscopy.
- This condition can be almost completely cured with surgery, so there is no need to worry.
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