Female Prostate, Saddle Bag and Spoke Wheel Signs-Classical Imaging Features of Urethral Diverticulum

A 32-year-old female presented with complaints of recurrent urinary tract infections, tender vaginal swelling and painful intercourse. She underwent repeated aspirations of anterior vaginal wall swelling by gynecologist considering it as primary vaginal cyst but the swelling was recurrent after short course of time. MRI imaging of pelvis was performed after the opinion of urologist considering the possibility of the infected urethral diverticulum. MRI examination revealed multiloculated fluid containing lesion around urethra appearing like saddle bag and spoke wheel on axial images and mimicking like enlarged prostate on sagittal images with submucosal enhancement and diffusion restriction of contents suggesting infected urethral diverticulum. Objective: We are discussing role of MRI imaging with the help of radiological signs in the accurate diagnosis of urethral diverticula in symptomatic patients to avoid painful and complicated interventional imaging procedures and narrow down the possibility of alternate diseases in the same territory.