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A urethral diverticulum is a fairly rare condition in which a "pouch" forms along the urethra, sometimes leading to pelvic pain, difficulty urinating, incontinence, and painful sexual intercourse.

When Carla, a 46-year old mother of two, noticed that she needed to go to the bathroom more and more often and yet didn't seem able to empty her bladder completely, she assumed that she had caught a urinary tract infection and made sure to drink lots of cranberry and apple juice. Things didn't get better when she did though, and just as she thought she would need to see her doctor for some antibiotics, she began experiencing startling new symptoms that couldn't be explained away by a UTI.

There was the slight "leakage" and the pain during sex, which could still indicate a urinary tract infection, but there was also something else — Carla had the definite feeling that something was coming out of her vagina. What was wrong? Could it be related to the perimenopause that she could now expect any time, or was she dealing with a pelvic prolapse of some kind? Carla had no idea and didn't particularly relish the thought of going to the doctor. One day, feeling brave, she decided to take a look at her vagina with a makeup mirror. Something was definitely up there that shouldn't be.

Her final diagnosis was something she never saw coming, because she had never heard of it before — and chances are that you haven't either.

What Is A Urethral Diverticulum?

"Urethral diverticulum" — the name itself gives some clues, suggesting that part of the urethra is "diverted". The urethra is, of course, the small tube through which urine is emptied from the bladder. When a "pouch" forms along the way, you end up with a urethral diverticulum. Urine can build up in this pocket, causing an uncomfortable bulge that can be felt from within the vagina, as Carla noticed. As you can imagine, such pockets can lead to frequent urinary tract infections, difficulties with urinating, and pelvic pain.

First described in the medical literature in 1805 by William Hey, it's hard to know how common urethral diverticula really are because many women remain asymptomatic. Men do occasionally get them too, but so rarely that focusing this article on women is more than justified. Urethral diverticula occur mostly in women between the ages of 40 and 70, and research suggests that they are present in approximately 16 percent of those who have suffered from frequent urinary tract infections. (Though one study found urethral diverticula in 4.7 percent of women who didn't have symptoms at all, the small sample size of 129 participants makes it impossible to say that this figure represents the prevalence of the condition within the general population.)

Though the cause of urethral diverticula is not clear right now, risk factors include frequent UTIs, having been pregnant and given birth, and a blockage of the glands surrounding the urethra. All of these things weaken the urethral wall.

In short, urethral diverticula are not all that common, but their presence is worth investigating in people who have symptoms that could point to one.
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