Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature
A three year old boy with a background of Russell Silver Syndrome presented to us with a soft, non-tender lump (1.5 cm) with a bluish hue on the ventral side of the penis in the region of the penoscrotal junction which persisted after voiding. [] The swelling was compressible and emptied on pressure with associated dribbling. Ultrasonography was performed to exclude renal anomalies. It showed that both kidneys were in orthotopic positions with no hydroureters or hydronephrosis. Micturating cystourethrogram (MCUG) revealed an AUD involving the mid portion of the penile urethra causing extrinsic compression of the urethra. [] The urethra proximal to the diverticulum was dilated and there was bilateral grade 2-3 vesicoureteric reflux. The posterior urethra was normal. Cystourethroscopy confirmed a large diverticulum of the anterior urethra without a valve. A provisional diagnosis of anterior urethral diverticulum was made. The patient underwent an open diverticular repair. A thin walled diverticulum was found extending into the subcutaneous plane. There was a wide communication with the native urethra. The diverticulum was excised and the defect was repaired in layers. He made uneventful recovery and the histology of the wall of the diverticulum revealed attenuated sparse smooth muscle with fibrosis.