Acquired male urethral diverticula: presentation, diagnosis and management.
OBJECTIVE
We describe the etiology, presentation, treatment and outcomes of men diagnosed with an acquired urethral diverticulum.


METHODS
We retrospectively analyzed the records of men with an acquired urethral diverticulum in an 11-year period (2000 to 2011) at a tertiary care reconstructive practice. Patient demographics, history, presentation, anatomical details such as diverticulum size and location, management and outcomes were recorded. Technical success was defined as unobstructed urination without urinary tract infection.


RESULTS
A total of 22 men with an acquired urethral diverticulum were included in analysis. Median age at presentation was 48.5 years (range 18 to 86). Most commonly, patients presented with recurrent urinary tract infection, urinary dribbling, incontinence or a weak urinary stream. Of the 22 men 12 (54.5%) underwent urethral diverticulectomy and urethroplasty, 3 (13.5%) underwent ileal conduit urinary diversion and 7 (32%) were treated nonoperatively. Select cases were managed conservatively when the urethral diverticulum was confirmed in a nonobstructed urethra, it was small or asymptomatic and it could be manually emptied after voiding. At a mean followup of 2.3 years there was a 91% urethral diverticulum recurrence-free rate.


CONCLUSIONS
Acquired male urethral diverticula are rare but should be considered when there is recurrent urinary tract infection, obstructive voiding symptoms, a history of hypospadias, urethral stricture or trauma, or prolonged urethral catheterization. Treatment options may include surgical excision of the urethral diverticulum or urinary diversion. Some patients may be adequately treated nonoperatively with post-void manual decompression.
Department of Urology, University of California-San Francisco, San Francisco, California 94117, USA.
Nadya M
NM
Cinman
Jack W
JW
McAninch
Allison S
AS
Glass
Uwais B
UB
Zaid
Benjamin N
BN
Breyer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014522:Urethral Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D055815:Young Adult