Double urethral obstruction in a neonate - a case report

Congenital anterior urethral diverticula with posterior urethral valve: A rare combination, case report

Background

Congenital anterior urethral diverticulum is a rare cause of urinary obstruction in children. Its association with posterior urethral valve is an exceedingly unusual occurrence.

Case presentation

18 month old male child for whom cystoscopic valve ablation was done for posterior urethral valve continued to have obstructive symptoms for which VCUG was done and revealed congenital anterior urethral diverticula. Open diverticulectomy and urethroplasty was done and he was discharged improved.

Conclusion

This case report represents a rare event in which two congenital causes of bladder outlet obstruction are combined and the presence of one masquaders the diagnosis of the other.

Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature

Anterior urethral diverticula are rare in children. Anterior urethral valves and associated diverticulum is the commonly discussed pathological entity in children. There is a lack of awareness among clinicians regarding less common presentations of anterior urethral diverticula in children; which can have a diverse involvement of the urinary tract. This report describes two uncommon presentations of anterior urethral diverticula in children, their diagnoses and management. A systematic differential diagnosis and review of anterior urethral diverticula in children is also presented.

Anterior and posterior urethral valves with subcoronal hypospadias: a rare association

Association of the anterior and posterior urethral valve is a rare congenital anomaly which can lead to various urinary tract symptoms. An 8-year-old boy was referred by his primary care physician for urinary dribbling, straining at micturition, and recurrent febrile urinary tract infection since the age of 2 years. Clinically, the bladder was palpable; both testes were normal, and, in addition, he had a subcoronal hypospadias. Diagnosis was confirmed by retrograde urethrogram and voiding cystourethrogram (micturating cystourethrogram) and urethroscopy. Cystoscopic ablation of both valves was done by electrocautery hook using low current at 5 o'clock and 7 o'clock directions. He voided with good flow and to completion. Urinary dribbling had completely subsided and renal function was normal at a follow-up period of 36 months with freedom from recurrent urinary tract infection. Both the anterior and posterior urethral valves develop from different embryological sources; thus, this association is rare. A case with this association has not been reported previously in the literature.

Congenital anomalies of the male urethra

The spectrum of congenital anomalies of the male urethra is presented. The embryologic basis of each anomaly, when known, is discussed. Clinical and imaging features of each entity are presented.