OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and ...OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS: Seventy-nine (4%) patients aged 41.2 ±.14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95%confidence interval [CI]-73%, 91%) had urethral diverticula, of which 4 (6%; 95%CI 2%, 14.8%) contained malignancies. Six patients (7%; 95%CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95%CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95%CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95%CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95%CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n= 32). CONCLUSION: Periurethral masses were encountered in less than 4%of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.展开更多
文摘OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS: Seventy-nine (4%) patients aged 41.2 ±.14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95%confidence interval [CI]-73%, 91%) had urethral diverticula, of which 4 (6%; 95%CI 2%, 14.8%) contained malignancies. Six patients (7%; 95%CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95%CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95%CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95%CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95%CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n= 32). CONCLUSION: Periurethral masses were encountered in less than 4%of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.
