# Case Report: Urethral Diverticulum after Distal Hypospadias Repair: An Uncommon Complication

## TL;DR

A 2-year-old child developed a rare complication called urethral diverticulum after hypospadias repair surgery, which was successfully treated with surgery and resolved completely.

## Contribution

This case report highlights urethral diverticulum as a rare but important complication of hypospadias repair in children.

## Key findings

- The child presented with voiding dysfunction and was diagnosed with a urethral diverticulum via ultrasound and cystourethroscopy.
- Surgical intervention resolved the symptoms, with no recurrence observed after 3 months of follow-up.
- The report emphasizes the importance of early detection and awareness of this complication among parents and physicians.

## Abstract

A urethral diverticulum can be defined as a pocket that forms from the lining of the urethra and protrudes into the surrounding tissue, a condition which causes voiding dysfunction and may result as a rare complication of hypospadias repair surgery.

We report the case of a 2-year-old child who presented to us in 2019 complaining of a thin forceful stream, ballooning of the ventral aspect of the penis while voiding, and post-void dribbling. He has a history of undergoing a tabularised incised plate urethroplasty for distal penile hypospadias at 18-months-old. Ultrasound showed increased post-void residual volume and cystourethroscopy confirmed a urethral diverticulum extending from the subcorona to the base of the penis. The patient underwent partial excision of diverticulum, urethroplasty, and meatoplasty. He was followed-up 3 months later with complete resolution of his symptoms and a normal urinary stream with no urethral ballooning or dribbling.

Urethral diverticulum may present as a complication post hypospadias repair. Although it is rare, we believe that it is important for the patient’s parents to understand the possibility and know of the signs and symptoms in addition to attending regular outpatient clinic appointments in order to facilitate early management if needed. Furthermore, it is highly important for physicians to assess newborns for hypospadias before carrying out circumcision as it is a contraindication for the procedure.