S237: Acquired giant urethral diverticulum and recurrent urolithiasis in a male paraplegic patient: A case report and review of literature

S237: Acquired giant urethral diverticulum and recurrent urolithiasis in a male paraplegic patient: A case report and review of literature Sarıkaya S., Şenocak Ç., Atabey E., Yıldırım M., Bozkurt Ö. Kecioren Training and Research Hospital, Dept. of Urology, Ankara, Turkey INTRODUCTION & OBJECTIVES: Urethral diverticulum is a rare pathologic entity. It can be divided into two groups as congenital and acquired. The complaints of patient, history and physical examination are so important for diagnose and also opacification and cystoscopy can be used. Diverticulum may be seen in anterior and posterior parts of urethra. Micturation cystourethrography, urethrography and magnetic resonance imaging are some of radiologic techniques that can be used for diagnose. In this case we present patient with a recurrent urolithiasis and anterior urethral diverticulum. MATERIAL & METHODS: A 40 year-old male patient presented to our clinic with left flank pain, dysuria, frequency, obstructive symptoms and sensation of incomplete emptying of urine. The patient was paraplegic and had a history of cerebral hemorrage after traffic accident. There was a satoghorn left kidney stone also in IVU. RESULTS: Left percutaneous nephrolitotomy was planned for the patient. Before that during the cystoscopy, a urethral diverticulum seen in urethra. According to physical examination there was a serious swelling in anterior part of scrotum (Figure 1) and on compression the urine was dribbling out of urethra. A urethrography was planned for the patient on postoperative 2nd month. And a 8 cmdiameter diverticulum seen in urethrography. An open diverticulectomy and primary repair was performed for the diverticulum. A 8 cm-diameter urethral diverticulum was excised (Figure 2). After the operation the urethral and drainage catheters was taken on postoperative 5th day and the patient was discharged on postoperative 6th day. And there was no complication after surgery on routine follow-ups.

CONCLUSIONS: The diagnose and choice of treatment method is so important especially for symptomatic urethral diverticula. There are nonoperative or operative approaches and several operative techniques that can be used for treatment. Eur Urol Suppl 2014; 13(7) e1561