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A urethral diverticulum is a localized outpouching or sac-like dilatation of the urethral mucosa that communicates with the urethral lumen. It is most commonly found in females and is often underdiagnosed due to nonspecific symptoms.

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Etiology

• Acquired (most common): Due to repeated infection or obstruction of periurethral glands (Skene's glands), leading to rupture into the urethral lumen and formation of a diverticulum.
• Congenital: Rare, associated with incomplete development of the urethra.

Epidemiology

• Predominantly in women aged 30–60 years.
• Estimated prevalence: 1–6% in women referred for lower urinary tract symptoms.

Clinical Features

Often presents with the classic triad (not always complete):

• Dysuria
• Dyspareunia
• Post-void dribbling

Other symptoms:

• Recurrent UTIs
• Urinary incontinence
• Anterior vaginal wall mass
• Hematuria or purulent discharge