Giant anterior urethral diverticulum with a calculus masquerading as left inguinal hernia: A missed diagnosis, a...

Area of Science:

• Pediatric Urology
• Congenital Abnormalities
• Urologic Surgery

Background:

• Congenital anterior urethral diverticulum is a rare cause of infravesical obstructive uropathy in pediatric patients.
• It typically manifests with obstructive or irritative urinary symptoms or penile ballooning during urination.

Observation:

• A case of a giant anterior urethral diverticulum with an internal calculus presented as a significant inguino-scrotal swelling.
• The swelling's size fluctuated with micturition, mimicking a cough impulse and leading to a misdiagnosis of left inguinal hernia.

Findings:

• The patient underwent an unnecessary left inguinal herniotomy, resulting in a urine leak from the surgical wound.
• This case highlights the diagnostic challenges posed by atypical presentations of congenital anterior urethral diverticulum.

Implications:

• Emphasizes the critical role of detailed patient history, thorough physical examination, and appropriate diagnostic imaging (e.g., ultrasound, voiding cystourethrography) in diagnosing such conditions.
• Underscores the importance of considering congenital anterior urethral diverticulum in the differential diagnosis of inguino-scrotal swellings in children.
• Stresses the need for tailored surgical approaches for complex cases of anterior urethral diverticulum to ensure optimal outcomes and prevent complications.