Rhabdomyosarcoma, Genitourinary

Contrast-enhanced voiding urosonography (CEVUS) as a novel technique for evaluation in a case of male urethral diverticulum

“…Although patients are typically asymptomatic from primary disease, symptomatic male patients present with complications of lower urinary tract obstruction, infection, calculi, or a palpable, spontaneously decompressing peno-scrotal mass. [ 1 2 3 4 6 ] Our patient, in addition to having intermittent urinary retention, presented with extensive upper urinary tract disease which had initially distracted from the diagnosis of urethral diverticulum. Although associated upper urinary tract involvement has occasionally been documented in patients with urethral diverticulum; nevertheless, no significant association between the upper and lower urinary tract pathology could be established in our patient.…”

“…Male urethral diverticulum is an uncommon entity, more frequently of acquired origin and its exact prevalence remains unknown. [ 1 2 3 4 6 ] The congenital variety is believed to occur due to developmental defects of the urethral folds, whereas the more common acquired variety (accounting for 67-90%) are secondary to traumatic insult. [ 1 3 4 6 ] The commonest locations are peno-bulbar region followed by bulbar urethra.…”

“…Imaging evaluation remains essential for confirming the diagnosis, documenting the site, size, and surrounding pathology, in patients with urethral diverticulum. [ 1 2 3 4 5 ] Although, traditionally, US is considered a supplementary technique modality for diagnostic evaluation of the urinary tract, very recent literature recommends CEVUS for investigation of VUR, urethral strictures, and diverticula in children. [ 8 9 10 12 ] CEVUS has been recommended as the modality of choice for the urinary tract in children, not only for its capability of dynamic display and safe repeatability but also for preventing radiation injury.…”

“…It refers to an abnormal outpouching from the urethral wall, into the adjacent fascia, which is in continuity with the urethral lumen. [ 1 2 3 4 ] Afflicted patients usually lack specific symptoms, although in a few, symptoms due to dribbling, lower urinary tract obstruction, calculi, and infection may prevail. Imaging investigations reveal the diagnosis in asymptomatic, but clinically suspected cases and confirm it in symptomatic patients.…”

“…Imaging investigations reveal the diagnosis in asymptomatic, but clinically suspected cases and confirm it in symptomatic patients. [ 2 3 4 5 ] The standard imaging protocol is a composite Retrograde urethrography (RGU) – Voiding cysto-urethrography (VCUG) examination. [ 1 4 5 6 7 ] Recent literature reports the utility of contrast enhanced ultrasound (CEUS) as a new technique for evaluation of urinary bladder, urethra, urethral diverticula, and vesico-ureteric reflux (VUR) in children and for urethral diverticula in women.…”