Antenatal sonographic findings of congenital anterior urethral diverticulum

Urethral Multiplicity: When Two Are Better Than One

Urethral multiplicity is a rare congenital anomaly that may be associated with lower urinary symptoms, whereas congenital urethral diverticulum is even more rare and may predispose to obstructive uropathy and urinary sepsis. We report 2 cases of boys with urethral multiplicity, to include urethral duplication associated with duplicated urethral diverticula and a case of urethral triplication.

Congenital anterior urethral diverticulum: antenatal diagnosis with subsequent neonatal endoscopic management

Congenital anterior urethral diverticulum is a rare cause of urethral obstruction in boys. We report on the antenatal diagnosis of this rare phenomenon, making this the sixth prenatally diagnosed case in the English literature (to the best of our knowledge). Our initial prenatal assessment, postnatal endoscopic management, along with the eventual clinical course is outlined. The embryologic theories, differential diagnosis, literature review, imaging, and treatment modalities of this entity are discussed.

Giant anterior urethral diverticulum with a calculus masquerading as left inguinal hernia: A missed diagnosis, a lesson to learn

Congenital anterior urethral diverticulum is an infrequent but important cause of infravesical obstructive uropathy in children. Clinical spectrum usually includes obstructive or irritative urinary symptoms or penile ballooning during the act of micturition. We share our experience in a case of giant anterior urethral diverticulum with a contained calculus presenting as a huge inguino-scrotal swelling and masquerading as left inguinal hernia. The fluctuation in the size of the swelling related to the act of micturition was mistaken for cough impulse. He was subjected to a left inguinal herniotomy, following which he developed urine leak from the surgery wound and was subsequently referred to our centre for further management. The importance of a detailed history, meticulous physical examination, and diagnostic imaging has been stressed. The surgical approach in such cases has also been highlighted.

Prenatal Diagnosis and Neonatal Management of Congenital Urethral Diverticulum

PURPOSE

We present a series of male neonates with prenatally detected anterior urethral diverticula and discuss postnatal management.

MATERIALS AND METHODS

We retrospectively reviewed 3 cases of prenatally detected anterior urethral diverticula presenting between 1998 and 2005.

RESULTS

An anterior urethral cystic mass was identified prenatally in all 3 patients. One mass spontaneously ruptured prenatally. The patient underwent diverticulectomy and urethroplasty at age 6 months. Two patients had obstructive uropathy with oligohydramnios and were delivered at 32 weeks of gestation. Both cases were managed by urethrostomy and subsequent diverticulectomy and urethroplasty at age 6 months.

CONCLUSIONS

Infravesical obstruction from a urethral diverticulum can be accurately identified and differentiated from other causes prenatally. Marsupialization is an excellent option for temporary urinary diversion when the clinical situation precludes primary excision and repair.