Congenital Posterior Urethral Diverticulum in a Male Child Case Report

Bindey Kumar,Prem Kumar,Zaheer Hasan

doi:10.3126/jnps.v32i3.5914

Abstract

Bladder neck and posterior urethra are common sites for obstructive uropathy in children. Diverticula of posterior urethra are rare cause of obstruction in children. A six year old boy presented with features of bladder outflow obstruction since birth. Ultrasound findings were suggestive of posterior urethral valve. Micturating cystourethrogram and endoscopic examinations revealed posterior urethral diverticulum which was placed dorsally. Diverticulectomy and reconstruction of urethra was performed by midline perineal incision. This report emphasizes that a posterior urethral diverticulum may be considered in those cases where features are suggestive of posterior urethral valve bladder outflow obstruction. DOI: http://dx.doi.org/10.3126/jnps.v32i3.5914 J. Nepal Paediatr. SocVol.32(3) 2012 257-258

Highlights

Posterior urethral valve causing bladder outlet obstruction with back pressure changes is known in children but similar picture may be caused by congenital posterior urethral diverticula
Proposed etiopathogenesis of posterior urethral diverticulum is that it can swell up significantly during micturition compressing bladder neck and urethra from posterior aspect resulting in outlet obstruction and its antecedent complications[3]
We have noticed that posterior urethral diverticulum was deficient of corpous spongiosum

Summary

Introduction

Posterior urethral valve causing bladder outlet obstruction with back pressure changes is known in children but similar picture may be caused by congenital posterior urethral diverticula. We report a case of six year old boy who had features of bladder outflow obstruction. Micturating cystourethrogram revealed posterior urethral diverticulum which was suspected to have posterior urethral valve on ultrasonography, subsequently reconfirmed on cystourethroscopy. Ultrasonography revealed thickened, trabeculated bladder and dilated posterior urethra. Micturating cystourethrogram revealed cystic dilatation in the region of posterior urethra which was placed dorsally resulting in bladder outflow obstruction with large postvoid residual urine volume (Figure 1).

Results

Conclusion