Abstract
We report a case of congenital anterior urethral diverticulum accompanied by complications of the urinary tract at the time of diagnosis, in which staged surgical treatments were performed. A male infant had repeated urinary tract infections since he was 7 months old. He was referred to our hospital as a voiding cystourethrogram at 11 months old showed severe bladder deformity, right VUR (grade 4) and urethral diverticulum located in the pendulous part. We speculated that a lower urinary tract obstruction due to anterior urethral diverticulum induced retrograde high pressure on the bladder and right VUR. Cystourethroscopy was performed at 12 months old and revealed a membranous stenosis at the distal lip of the diverticulum; therefore endoscopic resection of the membrane was done. However, no reduction of the diverticulum was observed after that. We performed diverticulectomy when he was 17 months old, resulting in the disappearance of urethral dilatation. However, as no improvement was observed for the right VUR, an antireflux operation (Cohen procedure) was added at the age of 24 months. Renal scintigraphy showed no deterioration of split renal functions after these operations.
