A single-center experience of symptomatic male urethral diverticula

To describe our experience of the etiology, presentation, management and outcomes of male urethral diverticula, which are uncommon, with few reports of large series published.

Twenty-one patients with male urethral diverticula were treated at a single institution during a 7-year period. Their case notes were retrospectively reviewed.

Of the 21 diverticula, 7 (33.3%) were congenital as determined from the history and histologic analysis. These 7 patients' mean age at presentation was 25 years, and they complained mainly of obstructive symptoms, poor bladder emptying, and a palpable perineal swelling. The 14 patients with acquired diverticula presented later, at a mean age of 35 years, but with almost identical symptoms and signs. The most common aetiolgical factors included trauma in 3, urethral stricture disease in 3, and previous urethroplasty in 3. The anterior urethra and penoscrotal junction were the most commonly affected sites in both groups (18 of 21). Overall, 12 patients underwent open surgical repair, 6 underwent endoscopy, and in 3, the diverticulum was left in situ. Postoperative complications were more frequent in the acquired group (64% versus 27%) and included urethrocutaneous fistula in 5, urethral stricture in 2, and wound infection in 4.

Urethral diverticula are uncommon, but should always be considered in young men with lower urinary tract symptoms or in those with a history of urethral trauma. Treatment should be individualized and determined according to the patient's fitness and the site and size of the diverticulum.