Combination Of Intraluminal And Contrast-enhanced Sonourethrography In Diagnosing The Female Urethral Diverticula

ObjectiveThis study summarizes the ultrasonographic features of female urethral diverticula(UD)retrospectively.It also demonstrates the effectiveness of combination of intraluminal and contrast-enhanced sonourethrogrphy in diagnosing the female UDs.MethodsA retrospective study was performed with 25 consecutive women who were diagnosed and treated as UD between January 2012 and March 2015.All the patients were preoperatively evaluated using intraluminal ultrasonography.The number,location,configuration,size,and type of the UD were assessed.Thirty-four female patients who had been highly suspected of UD underwent intraluminal and contrast-enhanced sonourethrography between April 2015 and March 2017.Eleven of them also underwent MRI examinations afterwards.All these 34 patients underwent surgery within 1 month after the imaging and we compare the results between ultrasound/MRI and surgical findings.ResultsTwenty-eight diverticula were found on intraluminal ultrasonography in the retrospective study.Twenty-two patients had single diverticulum,while the other 3 had double diverticula.The locations included proximal(14%),mid(46%),and distal(40%)urethra.In transverse section,the configuration presented as round or oval(46%),and horseshoe-like or circumferential(54%).The maximal diameter of the 28 diverticula ranged from 3mm to 48 mm.The types contained simple UD(36%)and complex UD(64%).Among the 34 patients,38 paraurethral cystic lesions were detected on ultrasonography and 24 were confirmed as UDs by intraoperative findings and postoperative pathology.Intraluminal and contrast-enhanced sonourethrography diagnosed 23 UDs(sensitivity and specificity respectively: 95%,100%)and MRI imaging diagnosed 12 in 13 UDs(sensitivity and specificity respectively: 92%,100%).Ultrasound imaging had good consistency with MRI(Kappa>0.75).ConclusionsVarious sonographic characters of female UDs could be observed during the evaluation,including single or multiple diverticula,different sites,diverse shapes,and septa,calculi or neoplasm inside diverticulum,all of which could be clearly displayed on intraluminal ultrasonography.Combination of intraluminal and contrast-enhanced sonourethrography had high sensitivity and specificity in diagnosing female UDs.It also had good consistency with MRI.