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- Title
Utility of clinical parameters, cystourethroscopy, and magnetic resonance imaging in the preoperative diagnosis of urethral diverticula.
- Authors
Pathi, Sujatha; Rahn, David; Sailors, Joseph; Graziano, Vincent; Sims, Robert; Stone, Rebecca; McIntire, Donald; Wai, Clifford
- Abstract
Introduction and hypothesis: Our purpose was to assess the accuracy of history and physical, cystourethroscopy, and magnetic resonance imaging (MRI) in preoperative diagnosis of urethral diverticula. Methods: This was a retrospective review of all patients who underwent surgical excision of periurethral masses between 1998 and 2009. Presenting symptoms and examination and cystourethroscopic findings were noted. A single pathologist reviewed all cases and provided the reference standard for the diagnosis of a diverticulum. A single radiologist reviewed all preoperative MRI studies. Sensitivities, specificities, and positive and negative predictive values (PPV, NPV) were determined. Results: Diverticula were diagnosed in 36/60 (60 %) patients. Transurethral fluid expression on palpation and recurrent urinary tract infection (UTI) had high PPV. Sensitivity, specificity, PPV, and NPV, respectively, for cystourethroscopy were 33 %, 100 %, 100 %, and 42 %; for MRI, these were 100 %, 83 %, 92 %, and 100 %. Conclusion: These data reinforce the utility of transurethral fluid expression for preoperative evaluation of urethral diverticula. Additionally, MRI is an excellent adjunctive diagnostic tool and may assist in establishing the diagnosis when there is high clinical suspicion of a urethral diverticulum but nonconfirmatory findings on cystourethroscopy.
- Subjects
DIVERTICULUM; MAGNETIC resonance imaging; URETHROSCOPY; URETHRA examination; URINARY organ diseases; URINARY tract infections
- Publication
International Urogynecology Journal, 2013, Vol 24, Issue 2, p319
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-012-1841-9