Indian Journal of Urology
CASE REPORT
Year
: 2003  |  Volume : 20  |  Issue : 1  |  Page : 70--71

Congenital anterior urethral diverticu­lum in an adult patient with end stage renal disease


Pranjal Ramanlal Modi, P Jacob John, Deepak Pravinbhai Joshi, Rohit Naranbhai Joshi 
 Department of Urology and Transplantation, Institute of Kidney Diseases and Research Centre, Civil Hospital Campus, Ahmedabad, India

Correspondence Address:
Pranjal Ramanlal Modi
A-161, Sarvodaya Nagar 1, Sola Road, Ghatlodia, Ahmedahad - 380 061
India




How to cite this article:
Modi PR, John P J, Joshi DP, Joshi RN. Congenital anterior urethral diverticu­lum in an adult patient with end stage renal disease.Indian J Urol 2003;20:70-71


How to cite this URL:
Modi PR, John P J, Joshi DP, Joshi RN. Congenital anterior urethral diverticu­lum in an adult patient with end stage renal disease. Indian J Urol [serial online] 2003 [cited 2020 Oct 28 ];20:70-71
Available from: https://www.indianjurol.com/text.asp?2003/20/1/70/37135


Full Text

 Case Report



A 30-year-old male patient presented with end stage renal disease. Ultrasonography revealed bilateral small echogenic kidneys without hydronephrosis and normal bladder. On evaluation for renal transplantation he had a history of poor urinary stream which was confirmed by uroflowmetry. Voiding cystourethrogram (VCUG) re­vealed anterior urethral diverticulum at the junction of penile and bulbar urethra [Figure 1]. Urethroscopy did not reveal any opening of the diverticulum. During explora­tion a saccular urethral diverticulum with a narrow neck and associated anterior urethral valve was found [Figure 2]. Excision of the valve and the redundant diverticular wall followed by urethral reconstruction yielded good results. Postoperative voiding urethrogram revealed a normal caliber urethra with a good stream of urine.

 Comments



Urethral diverticulum may be congenital or acquired. Congenital diverticula are located in the ventral aspect of the anterior urethra. Various theories for its etiology are given which include partial absence of corpus spongiosum or spontaneous rupture of paraurethral cyst within the lu­men of the urethra. Clinically, most of the patients having anterior urethral diverticulum are found during childhood; rarely an adult patient may present with infection or stone within a diverticulum. [1],[2] Finding a diverticulum at pretrans­plant evaluation is extremely rare especially if it is not the cause of renal failure. The symptoms depend largely on the size of the diverticulum. Diverticulum fills during void­ing which compresses distal urethra leading to poor urine flow. Since stasis of urine may lead to infection, excision of urethral diverticulum prior to renal transplantation should be done. Anterior urethral diverticulum can be managed endoscopically. [3]

References

1Sirota L, Katz RM Samuel N, Bar ZJ, Dulitzky F. Congenital ante­rior urethral diverticulum associated with bilateral urinomas and dysplastic kidneys. Hely Paediatr Acta 1986: 41(4): 353-7.
2Monish A, Rajiv TP, Dorairajan LN, Gupta NP. Infected congenital urethral diverticulum in an adult male. Urol Int 1999; 62(3): 177-9.
3Zia ul Miraj M. Congenital anterior urethral diverticula in children. Pediatr Surg Int 1999 ; 15(8): 567-9.