Male Urethral Diverticulum A Rare Entity: Our Experience

Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Diverticula of the female urethra are fairly common. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. We present two cases of male urethral diverticulum. Case 1: 37 year male patient presented with swelling and discharge from Peno-scrotal junction at the time of micturation for 4 years. Clinically cystic Peno scrotal swelling was palpated and a urethra-cutaneous fistula was suspected. RGU revealed oval sac like structure at mid penile urethra. Cystoscopy confirmed presence of diverticulum with urethra-cutaneous fistula. Managed with urethral diverticulectomy with urethral reconstruction. Case 2: 35 year male presented to us with straddle urethral injury with acute urinary retention. Clinically meatus was stenosed, with blood at meatus. Emergency SPC Trocar was done, RGU after 6 weeks revealed 2.5x1.5 cm sac like structure at Peno-bulbar junction with meatal stenosis. Meatoplasty with excision of diverticulum with end to end anastomosis was done. Acquired UDs occurs secondary to stricture, infection, trauma, long standing impacted urethral stones or scrotal / skin flap urethroplasties. RGU and MCU are the best diagnostic technique to confirm and characterize the UD. Urethral diverticulectomy with urethral reconstruction is the recommended treatment for UD. Management should be individualized on patient basis.