Editing Female Urethral Diverticulae (section)

=== History and Physical Exam ===

==== History ====
* '''<span style="color:#ff0000">Signs and Symptoms'''
**'''Notable for a range of clinical presentations ranging from completely asymptomatic (up to 20% of patients), incidentally noted lesions on physical examination or imaging, to very debilitating, painful vaginal masses associated with incontinence, stones, severe dyspareunia, and/or tumors'''
** '''<span style="color:#ff0000">Most common symptoms (3):'''
**#'''<span style="color:#ff0000">Storage LUTS'''
**#'''<span style="color:#ff0000">Pain'''
**#'''<span style="color:#ff0000">Infection'''
**#*'''<span style="color:#ff0000">Multiple bouts of recurrent cystitis should alert the possibility of a urethral diverticulum'''
**#** Reinfection, inflammation, and recurrent obstruction of the neck of the cavity are theorized to result in patient symptoms and enlargement of the diverticulum. This expansion occurs most commonly ventrally, resulting in the classic anterior vaginal wall mass palpated on physical examination in some patients with UD. However, it is important to note that these may also expand laterally, or even dorsally, about the urethra. Eventually, the abscess cavity ruptures into the urethral lumen, resulting in the communication between the UD and the urethral lumen.
** '''<span style="color:#ff0000">Other symptoms (8):'''
**#'''<span style="color:#ff0000">Dysuria'''
**#'''<span style="color:#ff0000">Hematuria'''
**#'''<span style="color:#ff0000">Post-void dribbling'''
**#'''<span style="color:#ff0000">Urinary retention'''
**#'''<span style="color:#ff0000">Incontinence (stress or urge)'''
**#'''<span style="color:#ff0000">Dyspareunia'''
**#'''<span style="color:#ff0000">Vaginal mass'''
**#*'''Patients may present with complaints of a tender or nontender anterior vaginal wall mass, which upon gentle compression may reveal retained urine or purulent discharge per the urethral meatus.'''
**#'''<span style="color:#ff0000">Vaginal discharge'''
**Vaginal pruritis is not a symptom associated with urethral diverticulum
** '''Size of the UD does not correlate with symptoms'''

==== Physical Exam ====
* '''<span style="color:#ff0000">Genitals'''
**'''<span style="color:#ff0000">Urethra may be gently “stripped” or “milked” distally in an attempt to express purulent material or urine from within the urethral diverticulum'''