Lacuna magna in 6 boys with post-void bleeding and dysuria: alternative approach to treatment

Six boys from 8 to 17 years old presented with blood dripping from the meatus at the termination of urination, spotting of blood on underwear and/or distal penile dysuria. Repeat urinalyses and cultures were negative, and evaluation included a voiding cystourethrogram. Diagnosis was lacuna magna in the area of the fossa navicularis, which was confirmed by cystoscopy. Each patient was treated endoscopically using a pediatric resectoscope and right-angle wire electrode. The value was incised with the cutting current and the base of the diverticulum was fulgurated. We find that this method of treatment is preferable to incision with tenotomy scissors.