Anterior urethral valves and diverticula

Abstract

Obstructive lesions of the anterior urethra (valves, diverticula) are rare and can be difficult to diagnose. One recent case led us to review existing international reports; there are case histories for 260 patients over a 20‐year period. The anatomical interpretation of these lesions is far from being unequivocal but many authors clearly distinguish between valves and diverticula, the basic difference being in the contiguity between the anomaly and the corpus spongiosum. Where the clinical presentation depends on age, the diagnosis depends essentially on voiding cysto‐urethrography, which must image the whole urethra. Generally, the treatment for valves is simple, consisting of endoscopic resection. For diverticula it is not always necessary or desirable to remove the diverticulum; if there is a well‐formed distal obstructing lip, removing it may be enough to cure the obstruction.

A congenital anterior urethral diverticulum associated with obstructive urinary symptoms in a 1-year-old male child: A case report and review of the literature

“…Over the past 20 years, 260 cases have been reported [1]. Several possible causes of the congenital diverticulum have been suggested, including a developmental defect of the corpus spongiosum, cystic dilatation of the urethral glands, and sequestration of an epithelial nest after closure of the urethral folds [2].…”

Congenital anterior urethral diverticulum presenting as a scrotal mass in a two-year-old child

“…8 Although some authors distinguish between urethral diverticula and anterior urethral valves, others believe they belong to a spectrum of obstructive anterior urethral conditions. 9 While there is little doubt of the congenital origin of these lesions, no family pattern of inheritance was detected in this case. 9 The etiology of this rare condition has provoked controversy for years.…”

“…9 While there is little doubt of the congenital origin of these lesions, no family pattern of inheritance was detected in this case. 9 The etiology of this rare condition has provoked controversy for years. Various proposed hypotheses include a ruptured syringocele, incomplete hypospadias, cystic dilatation of the periurethral glands, developmental defects of corpus spongiosum, incomplete fusion of a segment of the urethral plate, sequestration of an epithelial nest after closure Congenital anterior urethral diverticulum of urethral folds, and the presence of epidermal pockets communicating with the ventral urethral wall.…”

Húgycsődivertikulum radikális prostatectomia után

“…Ezt retrográd uretrográfia és uretroszkópia elvégzésével ellenőrizhetjük, amelyek a húgycső -di ver ti kulum diagnosztikájának gold standard módszerei (3). Az uretrográfia által kimutatott húgycsővel összefüggő telődési többlet a divertikulumon kívül az alábbi kórképek gyanúját vetheti fel: megalourethra, syringokele (a Cowper-mirigy kóros tá-gulata) és az elülső húgycsőbillentyű okozta proximalis húgy- csőtágulat (11,12). Nem egyértelmű diagnózis esetében további vizsgálatok, mikciós uretrográfia, medence MR-és transrectalis UH-vizsgálat lehet a segítségünkre (5, 13).…”

“…A műtéti kezelés legkevésbé invazív formája a divertikulum nyílásának vagy falának transurethralis reszekciója. Ez leginkább gyermekeknél és kisméretű divertikulumoknál hatékony (11,12). Nagy, panaszt okozó divertikulumok esetén nyílt műtét javasolt.…”