A 15-month-old male child presented with
a ventral penile mass starting from the peno-scrotal
junction and involving the whole penis since birth, which
was getting more prominent during micturition (Fig.
1). There was history of dribbling of urine, poor
urinary stream and urinary tract infection. On compression
of mass, urine dribbled from the meatus. Blood biochemistry
was normal. Ultrasound and micturating cystourethrogram
showed a large anterior urethral diverticulum (Fig.
2). Rest of the genito-urinary system examination was
normal. Excision and repair of the diverticulum was done.
During postoperative follow up, the child had normal looking
penis with good urinary stream.
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Fig. 1 Penile mass starting from the peno-scrotal
junction and involving the whole penis.
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Fig. 2 Micturating cystourethrogram
showing a large anterior urethral diverticulum
(arrows).
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Congenital anterior urethral diverticula
are rare, accounting for only 10 to 20% of all diverticula
of the anterior urethra and may be overlooked at a cursory
examination, unless kept in mind. This condition may present
later in adulthood with similar symptoms and signs or
hydrocele or a stone in the diverticulum. The differential
diagnosis includes – congenital anterior urethral valve,
dilated Cowper’s gland duct, and perforated syringocele. In
the absence of swelling, the diagnosis depends on
urethrography.
