JAMES S. KRIEGER, M.D.
Department of Gynecology
EUGENE F. POUTASSE, M.D.
Department of Urology
DIVERTICULUM of the female urethra is said to be a rare condition. Thirty-eight women afflicted with this pathologic condition have been seen in this institution since 1932. Engel1 and Higgins2 have reported previous cases. Twenty-six of these patients have been observed since the last report in 1945. This increased frequency of diagnosis does not reflect a change in the natural occurrence but instead indicates increased interest in case identification.
A diverticulum represents an outpouching of the ventral wall of the urethra and is, as a general rule, the end result of infection of a periurethral gland. It is usually manifested by a tender palpable swelling along the anterior vaginal wall. There is a direct communication, single or multiple, with the urethra which allows intermittent drainage of the sac contents. With continued adequate drainage the diverticulum may be asymptomatic. Since periurethral glands contain numerous branches and surround the urethra laterally, the diverticulum may be unilocular or multilocular and may even girdle the urethra in a saddle-like fashion.
The following case report is presented to emphasize the clinical features as well as diagnosis and treatment of this condition.
In June 1951, a 45 year old woman came to the Cleveland Clinic complaining of urethral pain and aching, especially with distention of the bladder. She was the mother of two children, her last pregnancy ending uneventfully in 1941. For the past 12 years she had had repeated attacks of dysuria, frequency, and urgency. The patient had noted a swelling in the vagina and. . .