title: Posterior urethral diverticulum after laparoscopic-assisted repair of high-type anorectal malformation in a male patient: surgical treatment and prevention.
abstract: Currently, laparoscopic-assisted colon pull-through (LACPT) is the treatment of choice for male patients with high-type imperforate anus and rectourethral fistula. Since laparoscopy was introduced for treating this condition, reports concerning post-LACPT complications are rare. Here we discuss the case of a boy, now 3.5 years old, born at 37 weeks' gestation weighing 2,300 g, who was diagnosed with rectobulbar urethral fistula (RUF) at birth. LACPT was performed when the boy was 11 months old and weighed 7.2 kg. No intraoperative complications occurred, and the initial post-LACPT course was uneventful. When he was 2 years old, he developed dysuria requiring urethral catheterization. Diagnostic radiology confirmed a large cystic mass behind the bladder, suggestive of a posterior urethral diverticulum (PUD). Histopathology of the excised mucosa of the cyst showed colonic mucosa, confirming that the cyst was indeed an enlarged residual RUF. We discuss our treatment and our approach to prevention.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, 113-8421 Bunkyo-ku, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koga
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Okazaki
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yanai
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Takeshi
authors.initials: T
authors.lastname: Miyano
mesh_terms: D001006:Anus, Imperforate / Q000150:complications / Q000601:surgery*; D002675:Child, Preschool; D004240:Diverticulum / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D012003:Rectal Fistula / Q000150:complications / Q000151:congenital / Q000601:surgery*; D012086:Reoperation; D014522:Urethral Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D014548:Urinary Fistula / Q000150:complications / Q000151:congenital / Q000601:surgery*; D014567:Urography