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VR-26
(VS)
TRANSURETHRAL INCISION OF ANTERIOR URETHRAL DIVERTICULUM
(SYRINGOCELE)
Yasar ISSI
1
, ünal BIÇAKCI
2
, Beytullah YAGIZ
2
, R Cankon GERMIYANOGLU
1
, Ender ARITURK
2
and Ferit BERNAY
2
1) ONDOKUZMAYIS UNIVERSITY, UROLOGY, Samsun, TURKEY - 2) ONDOKUZMAYIS UNIVERSITY, PEDIATRIC SURGERY,
Samsun, TURKEY
PURPOSE
Here we present a 3 year old boy with disturbed urine flow with anterior urethral diverticulum.
MATERIAL AND METHODS
A 3 year old boy presented with symptoms of straining during micturition, weak urine flow, intermittent haematuria and
postvoid dribbling since birth. Physical examination and urinalysis were unremarkable and urine cultures were negative.
Initial ultrasonography revealed an increased bladder wall thickness with a bladder volume of 166 cc and a postvoiding
residual volume of 120 cc without any ureteral dilatation or hydronephrosis. Uroflowmetry revealed an obstructive
voiding pattern; maximum flow: 1.4 ml/sec, average flow rate: 0.7 ml/sec, voided volume:20cc, residual volume:130cc.
A micturation cystourethrogram revealed bladder trabeculation without vesicoureteral reflux. On urodynamic study,
bladder volume was 210 cc, bladder compliance was reduced and most of the bladder content was remaining residual.
The patient had undergone urethrocystoscopy which revealed a large urethral diverticulum (syringocele) located at the
anterior urethra and the bladder demonstrated severe trabeculation. Posterior urethra was normal. Diverticulum was
incised proximal to distally by monopolar cautery and complete unroofing was achieved.
RESULTS
Two months after the intervention, patient had undergone uroflowmetry, urodynamic study and urethrocystoscopy
examinations. On uroflowmetry, maximum flow rate was 16.6 ml/sec and average flow rate was 4.7 ml/sec with a
residual volume of 20cc. On repeated urodynamic study bladder capacity was measured 170 cc and residual volume was
35 cc with a staccato micturition. On second-look urethrocystoscopy, no residual tissue that necessitate incision was
encountered.
CONCLUSIONS
Anterior urethral diverticulum must be considered while evaluating children with disturbed urine flow.