Treatment of urethral diverticulum after hypospadias repair - Report of two cases

Urethral diverticulum can follow surgical repair for hypospadias. Saccular dilatation of the neourethra may result from distal stenosis causing progressive dilatation, contained urinary extravasation from the breakdown of the repair, or initial creation of an oversized segment of the neourethra. In the past two years, two patients were treated at this hospital for urethral diverticulum after hypospadias surgery. Both cases had a stenotic lesion at the distal meatus and also had a fistula at penoscrotal junction. The presenting symptoms and signs included ventral bulging with voiding and post-void dribbling. Urinary stasis with chronic inflammation was also noted. The patients subsequently underwent urethral dilatation before diveticulum repair. The surgical correction involved a degloving circumferential skin incision, excision of the diverticulum and closure of urethra with overlapping suture lines. After diverticulectomy, one patient had a postoperative wound infection and developed an urethral fistula that needed repair one year later. Both patients voided with a straight full stream and had no other complications with a follow up at 1 year for one patient and 2 years for the other.