Congenital urethrocele in children. A case report
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Congenital urethrocele is a fairly rare disease in children. It corresponds to a saccular dilatation of a portion of the urethral wall which may be less or more huge. The diagnosis is often easy but the management remains difficult due to the risk of urethral stenosis form.

A 19-month-old boy with a history of urinary tract infections, referred to the surgical department by a family physician, for poor urinary flow. On examination, he had a fluctuant swelling on the ventral face of the penile urethra. This swelling was soft, cystic, fluctuant, and compressible. It collapsed completely on manual pressure with urine issue per urethra. Urine analysis, routine blood counts, and renal blood function were normal. Ultrasonography showed normal kidneys in size and shape with a normal bladder. Cystourethroscopy confirmed a urethrocele of the anterior urethra, Surgical exploration found that the urethrocele was extending into the subcutaneous plane. Urethrocele repair was performed by excision and a urethroplasty using the Firlit technique which consists of a reconstruction of the mucous collar around the glans. This technique permits to obtain a normal appearance of a circumcised penis. Post-operative recovery was uneventful. At 4 months follow-up the urinary stream was normal, with no urinary complaints. Parents are satisfied with the final result.

The diagnosis of anterior urethral diverticulum can be accurately made if this condition though less common is kept in mind. An early, precise diagnosis and awareness of the anterior urethral diverticulum in boys with obstructive symptoms can reduce the incidence of advanced uropathies.

In patients of the anterior urethral diverticulum with large diverticula without any back-pressure changes, as in the present paper, open diverticulectomy with a primary repair is recommended as this procedure carries good results, and it takes care of the redundant diverticular wall.