How is a urethral diverticulum diagnosed?

Usually a urethral diverticulum is found during a routine pelvic exam or because a woman tells her doctor about symptoms she’s having. At that point, the doctor does a physical exam or orders tests to try to find the cause.

In a physical exam, a doctor will feel the vaginal wall to try to find any masses, as well as to identify the location of any soreness. If they feel a sac, they may give a gentle squeeze to see if any built-up urine or pus comes out. The doctor would typically also order a urine analysis for a patient at this point.

If the exam leads the doctor to think there might be a problem, they can order imaging tests. These tests may include:

  • Magnetic resonance imaging: Magnetic resonance imaging (MRI) is a test that produces very clear pictures, or images, of the human body without the use of X-rays. MRI uses a large magnet, radio waves and a computer to produce these images. In people who might have a UD, the MRI will look all around the pelvis but particularly around the vagina to see if there are any masses present.
  • Ultrasound: This procedure transmits high-frequency sound waves, inaudible to the human ear, through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body. This can show the doctor if there are problems with the structures of internal organs around the vagina and if there is any swelling or build-up of urine.
  • Cystoscopy: This test involves looking into the urethra or bladder to see if a diverticulum can be identified and see the location of its opening. This is often done in the office.

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