De Vicari Desirèe, Barba Marta, Cola Alice, Frigerio Matteo
Department of Gynecology, IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy.
Biomedicines. 2025 Jun 11;13(6):1432. doi: 10.3390/biomedicines13061432.
Urethral diverticulum (UD) during pregnancy is a rare clinical condition, with limited literature available to guide standardized management. Fewer than a dozen well-documented cases have been reported, but they reflect a wide range of clinical approaches from antenatal surgery to postpartum intervention. We report the case of a 36-year-old woman diagnosed at 34 weeks of gestation with a 5.5 cm urethral diverticulum, presenting with suprapubic pain, urinary dribbling, and green vaginal discharge. Conservative management was pursued due to obstetric concerns, including multiple uterine fibroids and risk of preterm labor. Advanced ultrasonographic techniques-biplane transvaginal imaging, transperineal ultrasound, and 3D surface rendering-enabled a detailed anatomical assessment of parameters including the lesion's size, shape, and relationship to the urethra, without resorting to invasive diagnostics. The diverticulum was found to cause 90° urethral angulation and had a C-shaped configuration, with a volume of 11.5 cm. Following antibiotic treatment, the patient's symptoms improved, and she remained clinically stable. She was scheduled for vaginal delivery followed by postpartum diverticulectomy. This case illustrates the diagnostic value of high-resolution ultrasound in pregnancy and supports literature recommendations favoring conservative treatment and delayed surgery to reduce maternal and fetal risk. Vaginal delivery remains a viable option in select UD cases.
孕期尿道憩室（UD）是一种罕见的临床病症，可供指导标准化管理的文献有限。已报道的有充分记录的病例不足一打，但它们反映了从产前手术到产后干预的广泛临床方法。我们报告一例36岁女性病例，该患者在妊娠34周时被诊断出患有5.5厘米的尿道憩室，表现为耻骨上疼痛、尿滴沥和绿色阴道分泌物。由于产科方面的考虑，包括多发性子宫肌瘤和早产风险，采取了保守治疗。先进的超声技术——双平面经阴道成像、经会阴超声和三维表面成像——能够在不借助侵入性诊断的情况下，对包括病变大小、形状以及与尿道关系等参数进行详细的解剖学评估。发现该憩室导致尿道成90°角，呈C形结构，容积为11.5立方厘米。经过抗生素治疗后，患者症状改善，临床状况保持稳定。她计划进行阴道分娩，随后进行产后憩室切除术。该病例说明了高分辨率超声在孕期的诊断价值，并支持有利于保守治疗和延迟手术以降低母婴风险的文献建议。在某些UD病例中，阴道分娩仍然是一种可行的选择。
