Paraurethral masse in women - including cysts, diverticula, and leiomyomas-are frequently associated with lower urinary tract symptoms (LUTS), yet the degree of this association is often underestimated. Common complaints include urinary frequency, urgency, post-void dribbling, urinary incontinence, dysuria, and dyspareunia. This is the first systematic analysis of the impact of paraurethral masses on LUTS in women and to evaluate the effectiveness of surgical treatment.

A retrospective analysis was performed on 63 female patients who underwent surgical excision of paraurethral lesions between 2022 and 2024, with histopathological confirmation of the diagnosis. 
Preoperative data included patient-reported LUTS, physical examination findings, urine culture (n=30), and imaging (MRI or ultrasound; n=35). Postoperative outcomes were evaluated based on symptom resolution, recurrence, and intra/postoperative complications. The primary outcome was defined as full or significant resolution of LUTS after surgery.

Histological diagnoses: urethral diverticulum - 41%, paraurethral cyst - 41%, leiomyoma - 3%, others - 15%.
Most frequent preoperative complaints: palpable paraurethral mass - 32%, foreign body sensation - 24%, urinary incontinence - 14%, dyspareunia - 13%, urgency/dysuria - 11/63 (17%).
Postoperative improvement or complete resolution of LUTS was observed in 71.4% of patients.
Symptom recurrence was documented in 9.5% of cases, mainly due to incomplete excision.
Complications were reported in 3 patients (urethral wall defects); 2 cases involved calculi within a diverticulum.
All lesions were histologically benign.

The high prevalence of LUTS in patients with paraurethral lesions and their significant improvement following surgical treatment suggest a strong causal relationship. Urethral diverticula and paraurethral cysts equally contributed to symptomatic presentation. MRI proved effective for surgical planning.

Paraurethral lesions are a clinically relevant and underrecognized cause of LUTS in women. Surgical excision results in substantial symptom improvement in over 70% of cases. Careful preoperative assessment using imaging and meticulous surgical technique are key to optimizing outcomes and minimizing recurrence.