{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:39:48Z","timestamp":1768001988825,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T00:00:00Z","timestamp":1562371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Functional obstruction secondary to a high\u2010tone nonrelaxing sphincter (HTNRS) may lead to the formation of a proximal\u2010to\u2010mid\u2010urethral diverticulum (pmUD) in patients without a history of anatomical obstruction, vaginal delivery, vaginal and\/or urethral surgery, or periurethral gland infection, that is, a functional pmUD (fpmUD). We used measurements of the urethra\u2010sphincter complex volume (USCv) as a proxy for the maximal urethral closure pressure to evaluate this potential etiological factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared 17 consecutive women with fpmUD (mean age\u2009\u00b1\u2009SD of 49.4\u2009\u00b1\u200913.2 years) with a control group consisting of 24 age\u2010matched women (mean age: 50.8\u2009\u00b1\u200911.2 years) with no previous urological symptoms having MRI for posthysterectomy vesicovaginal fistula, and in all 71 women (mean age: 48.1\u2009\u00b1\u200911.6 years) with classical urethral diverticulum (cpmUD) referred in the same time period. The urethra\u2010sphincter complex was measured using T2\u2010weighted MRI and OsiriX<jats:sup>\u00a9<\/jats:sup> was then used to determine the USCv.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean USCv of the fpmUD group was 10.01\u2009\u00b1\u20096.97\u2009cm<jats:sup>3<\/jats:sup>. The mean USCv of the cpmUD was 5.19\u2009\u00b1\u20091.19\u2009cm\n<jats:sup>3<\/jats:sup> and for the control group was 3.92\u2009\u00b1\u20091.60\u2009cm\n<jats:sup>3<\/jats:sup>. There was a high statistically significant (<jats:italic>P<\/jats:italic>\u2009=\u2009.01) difference between the USCv in the fpmUD group and the USCv of both the cpmUD and the control groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with fpmUD demonstrated USCv that were significantly higher than those in women with cpmUD and the control group. These findings suggest that high pressure in the proximal urethra during voiding secondary to a HTNRS may contribute to the formation of urethral diverticula.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24080","type":"journal-article","created":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T11:59:15Z","timestamp":1562414355000},"page":"1859-1865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Urethral diverticula in women are associated with increased urethra\u2010sphincter complex volumes: A potential role for high\u2010tone nonrelaxing sphincter in their etiology?"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0408-0234","authenticated-orcid":false,"given":"Bashir M. 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