Congenital Anterior Urethral Diverticulum in aMale Teenager: A Case Report and Review of the Literature

A 13-year-old boy presented with a two-month history of dysuria, suprapubic discomfort, and poor urinary flow. There was no other significant history. Examination revealed no abnormalities. Urine culture, ultrasound of the urinary tract, and magnetic resonance imaging of the spine, pelvis, and urethra were all normal. However, the average urinary flow rate was only 2.1mL/s. Rigid cystoscopy revealed an anterior urethral diverticulum (Figure 1). A retrograde urethrogram showed persistent dilatation of the bulbar urethra. The patient underwent three urethroscopic incisions of the neck of the diverticulum over two years. After the first two procedures there was a temporary improvement in the urinary flow rate, followed by a worsening of symptoms due to scar tissue. Now the average flow rate is 12.2mL/s. The patient believes that his urinary flow has returned to normal. The plan is to monitor the urinary flow rate in the outpatient clinic and to repeat the diverticulum neck incision if the flow rate worsens.