Male Urethral Diverticulum with Stones Presenting as Acute Urinary Retention

Area of Science:

• Urology
• Surgical Innovation

Background:

• Acquired male urethral diverticulum is a rare condition, often resulting from interventions or distal urethral obstruction.
• Patients typically present with lower urinary tract symptoms (LUTS), and urethral calculi occur in 4-10% of cases.

Observation:

• A 63-year-old male presented with urinary tract infection (UTI) and acute urinary retention (AUR).
• Initial per-urethral catheterization failed; a supra-pubic catheter was placed, and UTI was treated with antibiotics.
• Workup revealed a large anterior urethral diverticulum containing multiple stones and associated urethral strictures.

Findings:

• The patient underwent successful endoscopic management.
• Procedures included optical urethrotomy for strictures and fragmentation/retrieval of calculi using a semi-rigid ureteroscope and pneumatic lithoclast.

Implications:

• This case demonstrates the efficacy of endoscopic techniques in managing complex urethral diverticula with associated pathologies.
• Minimally invasive endoscopic treatment offers a viable alternative for select cases of male urethral diverticulum with calculi and strictures.