Abrol N, Deshpande A V, Berry C S, Devasia A
Department of Urology, Christian Medical College, Vellore, Tamilnadu, India.
J Pediatr Urol. 2014 Aug;10(4):775.e1-2. doi: 10.1016/j.jpurol.2014.04.009. Epub 2014 May 21.
Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated.
A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function.
Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms.
Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient.
先天性前尿道憩室是一种罕见的病症。本教学视频展示了前尿道憩室的阴囊弹出机制以及一名男孩通过挤压阴囊排空膀胱的独特排尿模式。还展示了尿道镜检查和开放重建过程中的发现。
一名4岁男孩因排尿困难和排尿时阴囊肿胀前来就诊。排尿时的体格检查发现一个哑铃形前尿道憩室，伴有阴囊弹出，肾功能正常。
对憩室的阴囊部分进行了开放切除。使用来自阴茎球部尿道的去上皮化憩室壁瓣进行尿道成形术。随访时，男孩排尿顺畅，症状缓解。
通过手动挤压憩室完成排尿时的阴囊弹出可能有助于保留膀胱和肾功能。前尿道憩室的首选治疗方法是憩室开放切除并重建。憩室壁可用于在海绵体缺乏的腹侧加强修复。
