ABSTRACT
Suspected Anatomic Lesions Anatomic abnormalities, such as urogenital fistulae and urethral diverticula, might be suspected based on history or urodynamics but require an anatomic assessment for confirmation. For example, a diverticulum can be suspected based on a history of recurrent urinary tract infections, post-void dribbling, or pelvic pain. In such a patient, a biphasic urethral pressure profile is supportive of the diagnosis of a urethral diverticulum; however, Leach and Bavendam found that only 72% of patients with a urethral diverticulum demonstrated a biphasic pattern (12) . This contrasts with the reported diagnostic accuracy for cystourethroscopy of 84% to 90% ( 13 , 14 ). Beyond diagnosis, cystourethroscopy also provides important information about the size and location of the ostia, as well as the presence of multiple diverticula. The ability of cystourethroscopy to define the location, size, and surrounding anatomic relationships also pertains for urogenital fistulae, and both Massee et al. (15) and Symmonds (16) consider it the simplest method of evaluating urinary tract fistulae.
