Urethroperineal fistula in a patient with a stone in a bulbar diverticulum after a scrotal skin flap urethroplasty: A case report

摘要

The urethra is vulnerable to trauma, disease, or congenital defects and management options are often narrow.1 Urethral reconstruction has been done for years, and advances in techniques and procedures are ongoing. One of the oldest procedures is ventral scrotal skin flap urethroplasty, a procedure of which one of the most common complications is urethral diverticulum, thus the new trend of using a buccal mucosa urethroplasty. A urethral diverticulum is a localized pouch like dilatation extending from and adjoining to the urethra and is a rare clinical entity. Urethral diverticula in males are usually caused by trauma, infection, impacted stone or stricture disease.2 Rarely, it can develop as a complication of urological procedures.3 Urethral diverticulum with a urethral calculus causing a urethroperinial fistula is a rare and peculiar finding and has been reported only once before in English literature.4 We present a case of 62 years old male with a history of scrotal skin flap urethroplasty 30 years ago. The patient had a urethroperineal fistula extending from the ventral aspect of the penis towards the perineum associated with a diverticulum of the bulbar urethra with a taut of hair being a nidus for stone formation. To the best of our knowledge only one case in English literature has been published.4.