Apr 11, 2008

Urethral Diverticulum

Urethral diverticulum is the bag like sac arises from male urethra can be classified as congenital or acquired and further be subdivided into posterior or anterior. Congenital diverticula of anterior urethra are very rare and typically occur at the penoscrotal junctions.They are usually wide-mouthed and the distal edge may act as a valve that can obstruct the urine flow.Etiological factors in congenital diverticula include intrauterine distal urethral stenosis; lesser degree hypospadiasis or congenital cystic dilatation of the normal or accessory periurethral glands.

These anomalies are rare with no genetic predisposition. The clinical presentation depends upon the age & degree of presentation. In neonatal & infancy, symptoms related to urinary infection predominate while in older children voiding problems are presenting complaints.Usually the diverticula are saccular, communicating with urethral lumen. They are present on the ventral aspect of the urethra and are of variable size. During micturition urine enters into diverticulum distending it resulting in the obstruction to the flow of urine, more so when anterior urethral valves are associated with it.

The diagnosis depends essentially on voiding cystourethrography, which must opacify the whole of the urethra. Retrograde urethrography is sometimes needed in case of a giant diverticulum. The treatment of the diverticula is excision with urthroplasty or if associated with valves then endscopic resection of the valves.