Congenital urethral diverticulum with infertility in an adult man and review of the literature

Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum

BACKGROUND

Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs.

HYPOTHESIS/OBJECTIVES

Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS).

ANIMALS

Eight client-owned dogs with UD treated with an AUS.

METHODS

Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed.

INCLUSION CRITERIA

 diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow-up. Urinary continence score (UCS) was attributed retrospectively.

RESULTS

Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs).

CONCLUSION

Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.

Congenital urethral diverticulum in an adult male patient presenting with anejaculation

Male urethral diverticulum is an uncommon condition typically caused by previous surgeries, inflammation, or trauma. There are very few case reports of primary male urethral diverticulum, with only one report linking it to ejaculatory problems. In this report, we present a rare case of congenital male urethral diverticulum who presented with lower urinary tract symptoms and anejaculation that was successfully treated through open urethral diverticulectomy.