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Female urethra

The female urethra is a short, muscular tube that conveys urine from the bladder to the external urethral orifice. Unlike the male urethra, it serves only urinary function and measures approximately 3–4 cm in length. It is embedded within the anterior vaginal wall and closely associated with the pelvic floor musculature. Its short length makes it more susceptible to ascending infections such as cystitis.

The female urethra is surrounded by an external urethral sphincter complex that provides continence and is of surgical importance in pelvic reconstructive procedures. Its close relation to the anterior vaginal wall, clitoris, and pelvic diaphragm makes it a key structure in urogynecology and pelvic radiology.

Synonyms

  • Female urinary channel

  • Urethra feminina

  • Short urethra

Origin, Course, and Insertion

  • Origin: Begins at the internal urethral orifice of the bladder, located at the bladder neck

  • Course: Runs inferiorly and anteriorly, passing through the pelvic floor muscles and embedded within the anterior wall of the vagina

  • Insertion: Opens externally at the external urethral orifice, located in the vestibule of the vulva, between the clitoris and vaginal opening

Relations

  • Anteriorly: Pubic symphysis

  • Posteriorly: Anterior vaginal wall

  • Superiorly: Bladder neck and base

  • Inferiorly: Perineal membrane and external genital vestibule

Nerve Supply

  • Somatic innervation: Pudendal nerve (perineal branches)

  • Autonomic innervation: Pelvic plexus (sympathetic and parasympathetic fibers)

Arterial Supply

  • Internal pudendal artery (urethral branches)

  • Vaginal artery

  • Inferior vesical artery (minor contribution)

Venous Drainage

  • Venous drainage into the vaginal venous plexus and vesical venous plexus, which communicate with the internal iliac vein

Function

  • Conveys urine from the bladder to the outside of the body

  • Provides continence via the external urethral sphincter complex

  • Contributes to pelvic floor support and stability

Clinical Significance

  • Common site of urinary tract infections due to short length

  • Can be injured in pelvic trauma, childbirth, or gynecological surgery

  • Urethral diverticula and strictures are important clinical entities detectable on imaging

  • Evaluation critical in pelvic floor dysfunction and urinary incontinence

MRI Appearance

T1-weighted images:

  • Urethral wall appears as low-to-intermediate signal intensity

  • Surrounding fat is bright, aiding delineation

  • Chronic scarring may show low signal intensity

T2-weighted images:

  • Urethral lumen appears bright when fluid-filled

  • Urethral wall appears low-to-intermediate signal

  • Inflammation or edema presents as bright wall thickening

STIR (Short Tau Inversion Recovery):

  • Suppresses fat; normal urethra appears low-to-intermediate signal

  • Pathology such as diverticula or inflammation appears bright

Proton Density Fat-Sat (PD FS):

  • Urethral wall appears low-to-intermediate

  • Edematous or inflamed urethral wall shows bright signal intensity

T1 Fat-Sat Post-Contrast:

  • Normal urethra shows mild uniform wall enhancement

  • Inflammation, tumor, or abscess shows heterogeneous or rim enhancement

CT Appearance

Non-Contrast CT:

  • Urethra is not well-visualized due to small caliber; appears as soft tissue density embedded in anterior vaginal wall

  • Stones or calcifications, if present, appear hyperdense

Post-Contrast CT:

  • Urethral wall enhances mildly and uniformly

  • Diverticula, inflammation, or tumors appear as enhancing lesions

  • Abscess shows rim enhancement with central low density

MRI image

Female urethra MRI axial anatomy image-img-00000-00000

MRI image

Female urethra MRI axial anatomy image-img-00000-00000_00001

CT image

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CT image

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