Large Urethral Diverticulum Presenting as a Scrotal Mass:: Urethral Reconstruction With Ventral Onlay Buccal Mucosa

Jang, Thomas L.; Blunt, Lynn W.; Yap, Ronald L.; Brannigan, Robert E.; Gonzalez, Christopher

doi:10.1097/01.ju.0000099885.91561.e2

Cited by 11 publications

(12 citation statements)

References 3 publications

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“…15,16 If the urethral defect is large, extragenital grafts can placed ventral to avoid fistula formation and relapses derived from simple closure techniques. 17 Grafts obtained from hair bearing skin should be avoided.…”

Section: Discussionmentioning

confidence: 99%

Acquired Male Urethral Diverticula: Presentation, Diagnosis and Management

et al. 2012

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Purpose We describe the etiology, presentation, treatment and outcomes of men diagnosed with an acquired urethral diverticulum. Materials and Methods We retrospectively analyzed the records of men with an acquired urethral diverticulum in an 11-year period (2000 to 2011) at a tertiary care reconstructive practice. Patient demographics, history, presentation, anatomical details such as diverticulum size and location, management and outcomes were recorded. Technical success was defined as unobstructed urination without urinary tract infection. Results A total of 22 men with an acquired urethral diverticulum were included in analysis. Median age at presentation was 48.5 years (range 18 to 86). Most commonly, patients presented with recurrent urinary tract infection, urinary dribbling, incontinence or a weak urinary stream. Of the 22 men 12 (54.5%) underwent urethral diverticulectomy and urethroplasty, 3 (13.5%) underwent ileal conduit urinary diversion and 7 (32%) were treated nonoperatively. Select cases were managed conservatively when the urethral diverticulum was confirmed in a nonobstructed urethra, it was small or asymptomatic and it could be manually emptied after voiding. At a mean followup of 2.3 years there was a 91% urethral diverticulum recurrence-free rate. Conclusions Acquired male urethral diverticula are rare but should be considered when there is recurrent urinary tract infection, obstructive voiding symptoms, a history of hypospadias, urethral stricture or trauma, or prolonged urethral catheterization. Treatment options may include surgical excision of the urethral diverticulum or urinary diversion. Some patients may be adequately treated nonoperatively with post-void manual decompression.

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Section: Discussionmentioning

confidence: 99%

Acquired Male Urethral Diverticula: Presentation, Diagnosis and Management

et al. 2012

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“…Almost 200 cases of anterior urethral diverticula were reported between 1906 and 1997 [5] , but to our knowledge only 4 cases of urethral diverticula manifested as a scrotal mass have been reported to date [4] . Of all urethral diverticula reported, 80-90% occurred at the penoscrotal junction or bulbous urethra and were usually the result of acquired diseases such as traumas, infections, urethral catheterization lesions or postoperative urethral surgery complications [6] (1.5-18%) [3] .…”

Section: Discussionmentioning

confidence: 86%

“…Clinical manifestation includes symptoms that basically depend on age and the degree of obstruction that the diverticulum can cause. In adults clinical presentation includes irritative and/or obstructive voiding symptoms, such as straining to void, weak stream, interrupted stream, postvoid dribbling, painless swelling during voiding or hematuria, mass on the ventral urethral, scrotal or perineal mass [3][4][5][6][7][8][9][10] . Retrograde ejaculation has also been described.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical manifestation of urethral diverticula has been described with irritative and/or obstructive voiding symptoms or ventral bulging, but manifestation as a scrotal mass is extremely rare; only 4 cases have been reported [4] . Diagnostic imaging is useful for diagnosis and subsequently an effi cient treatment in the majority of cases, even if several postoperative complications have been described [5] .…”

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confidence: 99%

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Infected Congenital Urethral Diverticulum Manifested as a Scrotal Mass in an Adult Male: Case Report and Review of the Literature

et al. 2008

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Congenital anterior urethral diverticula in adult males are infrequent urological diseases. Clinical manifestation is frequently described with irritative and/or obstructive voiding symptoms or ventral bulging, but manifestation as a scrotal mass is extremely rare. Diagnostic imaging is useful to correctly diagnose the above in the majority of cases. We report the first case of a urethral diverticulum in which neither clinical nor instrumental evaluations were performed to confirm the diagnosis of urethral diverticulum. We stress the importance of a surgical approach in evaluating scrotal mass if diagnostic imaging cannot confirm an exact diagnosis. A complete review of the literature was also carried out.

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“…Whenever possible, maximum efforts should be made to reinforce the repair with surrounding tissues in an attempt to minimise the risk for development of urethrocutaneous fistulae 8 9…”

Section: Discussionmentioning

confidence: 99%

Acquired male urethral diverticulum: a complication following artificial urethral sphincter implantation

et al. 2013

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SUMMARYThe authors report a case of a 72-year-old patient who underwent radical prostatectomy in 2003 due to prostate cancer. During follow-up, he presented with permanent and severe urinary stress incontinence for which he underwent an artificial urinary sphincter implantation in 2009. After infection of the device, followed by the development of a urinary fistula, the artificial urinary sphincter was removed. He presented no new signs or symptoms for 2 years, during which he remained completely incontinent. In April 2012, he developed a painless scrotal swelling close to the median raphe. On manual compression, it showed urinary leakage and disappeared completely, only to reappear several hours later. Auxiliary examinations revealed a bulbar urethral diverticulum which was subsequently excised. A urethroplasty was performed during the same procedure. The patient presented with no further complications. Although still suffering from complete urinary incontinence, he refused any kind of surgery for the time being. BACKGROUND

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Large Urethral Diverticulum Presenting as a Scrotal Mass:: Urethral Reconstruction With Ventral Onlay Buccal Mucosa

Cited by 11 publications

References 3 publications

Acquired Male Urethral Diverticula: Presentation, Diagnosis and Management

Acquired Male Urethral Diverticula: Presentation, Diagnosis and Management

Infected Congenital Urethral Diverticulum Manifested as a Scrotal Mass in an Adult Male: Case Report and Review of the Literature

Acquired male urethral diverticulum: a complication following artificial urethral sphincter implantation

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