Transvaginal sonography in the diagnosis, management and follow-up of complex paraurethral abnormalities

Most urethral diverticula are thought to result from infection and obstruction of the paraurethral ducts and glands. When rupture of a resulting retention cyst or abscess occurs into the urethra, a diverticulum is formed. We report two cases of paraurethral abnormalities: urethral diverticulum and paraurethral abscess. Transvaginal sonography, with its high-resolution visualization of the lower urinary tract, may aid in the diagnosis and treatment of such disorders. Using three-dimensional technology, the internal architecture of the paraurethral abnormalities and their spatial relationship to the urethra and bladder, important considerations at surgery, are clearly demonstrated on ultrasonography. Complete excision of complex paraurethral anomalies may be performed under transvaginal sonographic monitoring without inadvertent injury to the bladder or urethra.