Congenital Anterior Urethral Diverticulum: A Case Report

Congenital anterior urethral diverticulum is a rare anomaly in male patients with voiding difficulty. We describe a 14-yr-old boy suffering from post-voiding dribbling. The retrograde urethrogram and cystourethroscopy revealed a congenital anterior urethral diverticulum at the bulbous portion of the urethra. He received a transurethral endoscopic resection of the neck of the diverticulum. After the operation, the patient voided with a good urinary stream with no post-voiding dribbling. We present this case and review the literature.

Short-term Complications After Pyeloplasty in Children With Lower Urinary Tract Anomalies

BackgroundCongenital anterior urethral diverticulum (CAUD) is a rare condition in children. This condition can present at any age; however, it is more commonly identified in infants and older children. The patient may present with difficulty in micturition, dribbling of urine, poor urinary stream, or urinary tract infection. Children with large anterior urethral diverticulum with poor spongiosal support may also complain of cystic ventral penile swelling during micturition.MethodsIn this series, we report seven such cases of congenital anterior urethral diverticulum treated over a period of 12 years (2008–2020). All cases presented to the Pediatric Surgery Department with dysuria, dribbling of urine, recurrent urinary tract infection, and/or fluctuant ventral penile swelling. They were further evaluated with retrograde urethrography with micturating cysto-urethrogram and cysto-urethroscopy.ResultsThree cases had anterior urethral valves that were managed by cystoscopic fulguration of valves. Surprisingly, all these three cases had concomitant posterior urethral valves, while the other four cases presented with relatively larger and saccular anterior urethral diverticulum required excision of the diverticulum and primary urethral reconstruction.ConclusionsThe cases with congenital anterior urethral diverticulum secondary to anterior urethral valves may also be associated with posterior urethral valves as seen in our case series. Surgeons should be aware of this association, and both valves should be fulgurated in the same sitting. A larger and saccular anterior urethral diverticulum requires excision and urethroplasty as a definitive procedure.

Congenital anterior urethral diverticulum

Congenital anterior urethral diverticulum (CAUD) is a rare congenital blind ended out pouching of the urethral through the corpus spongiosium. We report its coexistence with phimosis in a 7-year-old boy who presented with difficulty in passing urine. His prepuce was not retractable and balloons at voiding. Suspected associated CAUD was confirmed at circumcision. His voiding became normal with resolution of lower urinary tract symptoms after treatment. The related literatures were reviewed. The symptoms of the two conditions mimic one another and the diagnosis of phimosis which is clinical may overshadows CAUD with its needed confirmatory imaging studies. CAUD can coexist with phimosis and high index of suspicion helps in the management. Diverticulectomy and urethroplasty with circumcision at the same sitting is curative.

Voiding dysfunction and lower urinary tract symptoms (LUTS) in children due to congenital anomalies of urogenital system is common, but congenital anterior urethral diverticulum (CAUD) in male is very rare. Sometimes the problem is associated with anterior urethral valve. CAUD with secondary stone is rare. Here we report a case of a 12-year-old male child with obstructive symptoms. It was treated by excision of diverticulum, removal of stone and primary repair.J Enam Med Col 2017; 7(3): 162-164

Congenital anterior urethral diverticulum is a rare condition causing lower urinary tract obstruction in children. It usually arises from the ventral aspect of the anterior urethra, mostly located at the penoscrotal junction. We report a case of a 14-month-old baby boy who presented with a soft ventral swelling over the distal penile urethra, difficulty in passing urine, and a history of recurrent febrile urinary tract infections. A retrograde urethrogram revealed a large distal anterior urethral diverticulum. He underwent diverticulectomy and primary repair with no post-operative complications. The treatment of these depends on the size of the diverticulum and the degree of obstruction. In cases of a large anterior urethral diverticulum, open diverticulectomy and primary repair are recommended.

A patient with congenital anterior urethral diverticulum is described. He showed recurrent lower urinary tract infection, but he did not have severe upper urinary tract abnormalities. One-stage resection and urethroplasty were successfully performed before the upper urinary tract change developed. Anterior urethral diverticulum should be considered as a cause of recurrent lower urinary tract infection in young children.

Congenital Anomalies of Lower Urinary Tract

Congenital anterior urethral diverticulum is an uncommon condition in males. In my series a 15 years old boy with congenital anterior urethral diverticulum was presented with urinary symptoms and ventral penile swelling. The diagnosis was made on retrograde urethrogram (RGU) and micturiting cystourethrogram (MCU). The patient had normal renal function. Open diverticulectomy and primary urethral reconstruction was carried out uneventfully.
 CBMJ 2018 January: Vol. 07 No. 01 P: 45-47

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Acquired Male Urethral Diverticula: Presentation, Diagnosis and Management

Congenital Anterior Urethral Diverticulum (CAUD) and Anterior Urethral Valve (AUV) are rare but well-described causes of urinary obstruction in male children. The clinical presentation can range from isolated poor urinary stream with normal bladder and upper tracts to severe obstructive uropathy with renal failure. In the present case series, six children with anterior urethral obstruction managed between June 2014 and June 2024 were retrospectively identified. Age at presentation, clinical features, investigations, management and long-term follow-up were studied. The age at presentation ranged from newborn to seven years. Severe disease, as evidenced by progressive renal failure, was present in 1 of the 6 children (16.6%). One child had undergone foetal intervention by valve ablation but had progressive renal failure on follow-up. Three children (50%) underwent diverticulum excision with urethroplasty, of which one child developed a postoperative urethrocutaneous fistula. One child with AUV had a dorsal urethral fold causing obstruction, unlike the ventral pathology observed in the other children. CAUD and AUV are rare yet important causes of obstructive uropathy. Careful assessment is crucial for making the correct diagnosis. Temporary diversion may be essential when cystoscopy or primary repair is not feasible or in cases of urosepsis.

Congenital anomalies of kidney and urinary tract (CAKUT) are common fetal congenital malformations, accounting for 1% of all congenital malformations. The overall incidence of CAKUT is 0.3–0.6% [1]. CAKUT may have different clinical phenotypes, including renal cystic anomalies (such as polycystic renal dysplasia, polycystic renal disease, and obstructive cystic dysplasia), urinary tract obstruction-related diseases (such as renal hydrocele, posterior urethral valves, urorectal septum malformation sequence (URSMS), and megabladder), renal structural and positional anomalies (such as ectopic kidney, renal agenesis, kidney duplex, and horseshoe kidney), lower urinary tract anomalies (such as hypospadias), and associated malformations of the urinary tract (chromosome 17q12 deletion syndrome) [2].