Prolapse

• Prolapse of the urethra is known as an urethrocele, but is uncommon.

Incontinence

• The urethral muscle weakens as a consequence of aging and in the right circumstances
will give rise to urinary incontinence.

• When the anterior support to the urethra (pubo-urethral ligaments) is reduced due to
childbirth, the urethra tends to descend either during stress on the pelvic floor, or due to
change to the upright position, and may give rise to stress urinary incontinence.

Urethral diverticulum

• The female urethra may also be affected by a diverticulum, which burrows between the
mucosa and the muscle and may present as a painful swelling (or as an abscess).

• The removal of an urethral diverticulum requires care to avoid damaging the urethra
which may later give rise to a fistula, incontinence or both.

Urethral caruncle

• An eversion of the mucosa appears as a red swelling (urethral caruncle) at the urethral
orifice, which is often confused for a tumor.

Cystoscope

• Inserting a cystoscope through the urethra allows inspection of the inside of the bladder
and the ureteric orifices.

• The ureteric orifices may be cannulated with small tubes and special X-rays of the ureters
performed.

• Slide 1 and slide 2 show a cystoscopic view of the left ureteric orifice.