Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature
A 13-year old boy complained of poor urine stream and post void dribbling over the last few years with no documented urinary tract infections. He underwent a cystourethroscopy two years ago at another hospital that showed a narrowing in the anterior urethra and was dilated. He represented with worsening symptoms about a year later. The most recent ultrasonography demonstrated poor bladder emptying with a post-void residual of 250 ml at his first attempt. There was no hydronephrosis or hydroureter. A micturating cystourethrogram showed an urethral diverticulum in the area of the bulb causing extrinsic compression of the penile urethra. [] The urethra was otherwise normal and no vesicoureteric reflux was noted. He was subsequently referred to our service. He underwent a cystourethroscopy which confirmed a large urethral diverticulum with a narrow neck in the anterior urethra close to the bulb. [] Urethroscopic examination of the diverticulum revealed a tiny communication in its posterior wall suggestive of a possible communication with the duct of the Cowper's gland. The rest of the urethra appeared unremarkable. The diverticulum was deroofed using a resectoscope knife with cutting current. The patient's symptoms resolved and a repeat urethroscopy 6 weeks later showed no narrowing of the urethra and a slight expansion of the urethra in the area of the diverticulum but was otherwise normal.