Late-presenting congenital anterior urethral diverticulum causing renal impairment in a male child

Area of Science:

• Pediatric Urology
• Pediatric Nephrology
• Medical Imaging

Background:

• Congenital anterior urethral diverticulum (CAUD) is a rare congenital anomaly.
• Delayed diagnosis can lead to significant lower urinary tract obstruction and chronic renal impairment.
• This case highlights a rare late presentation of CAUD in a pediatric patient.

Observation:

• A 6-year-old boy presented with symptoms of lower urinary tract obstruction and chronic renal impairment.
• Initial diagnostic workup did not identify the cause.
• Voiding cystourethrography revealed a large anterior urethral diverticulum, confirming the diagnosis of isolated CAUD.

Findings:

• The patient's presentation with significant renal dysfunction was attributed to a delayed diagnosis of CAUD.
• The large anterior diverticulum was identified as the cause of the obstruction.
• This case underscores a critical diagnostic pitfall in pediatric urology.

Implications:

• Clinicians must consider CAUD in male children with unexplained renal insufficiency or voiding symptoms.
• Early detection and intervention are essential to prevent irreversible upper urinary tract damage.
• Voiding cystourethrography is a key diagnostic tool for identifying anterior urethral diverticulum.