Scrotal pop off in a congenital anterior urethral diverticulum. 2014

N Abrol, and A V Deshpande, and C S Berry, and A Devasia
Department of Urology, Christian Medical College, Vellore, Tamilnadu, India. Electronic address: nitinabrol@cmcvellore.ac.in.

OBJECTIVE Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated. METHODS A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function. RESULTS Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms. CONCLUSIONS Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient.

UI MeSH Term Description Entries
D008297 Male Males
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004240 Diverticulum A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT. Diverticulosis,Diverticula
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012611 Scrotum A cutaneous pouch of skin containing the testicles and spermatic cords. Scrotums
D014522 Urethral Diseases Pathological processes involving the URETHRA. Disease, Urethral,Diseases, Urethral,Urethral Disease
D016055 Urinary Retention Inability to empty the URINARY BLADDER with voiding (URINATION). Retention, Urinary

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