A Case of Urethral Diverticulum with Multiple Stones in it.

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A Case of Urethral Diverticulum with Multiple
Stones in it. Presented by Dr.Narayan
M.Patel M.D.D.G.O. FICS Emeritus Professor
Muni. Medical college Postal address-- Mahalaxmi
Institute of medical teaching 3 Shantiniketan
park Naranpura Nr.Sardar Patel Colony
AHMEDABAD- 380 014 (Gujarat) INDIA T.N.(079)
27682572 Mobile- 98252 95530 E mail-
nmpatel1932_at_wilnetonline.net

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This patient aged about 45 years came with
difficulty in passing urine and burning sensation
while passing urine. She also complaint of some
swelling at vagina since last one year. On the
vary first examination we could think of it as
a case of urethral diverticulum. On further
palpating it we could also feel stones in it.
X-ray pelvis confirmed it as multiple stone.
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Picture-1
Picture-2
A case of urethral diverticulum. Foleys Catheter
is in urethra You do not see cervix as seen in
picture no. 2 is of prolapse uterus. This is one
of the way to differentiate a case of urethral
diverticum from prolapse.
A case of prolapse uterus and not of
divertculum as you see cervical opening
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stones
stones
X-ray of pelvis shows multiple radio opaque
stones. Pl note that they are out side
pelvis. This is due to position of stones in the
diverticulum. If stones were in bladder they
will be within pelvis. The next picture shows a
close up view of the first picture.
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Foleys catheter was first put in urethra. The
wall of diverticulum was dissected up to its
neck and when the neck of diverticum was
reaches it was opened up. All the stones in the
diverticum were removed a good wash by
saline was given to the operating area.. On
opening the neck of diverticum the Foleys cater
was seen. This opening was closed in 2 layers by
using 3/0 vicryl. Excess wall of diverticulum
was excised and sutured. Catheter was kept in
situ for 7 days Pt. was given antibiotics.
Recovery was uneventful.
Patient was operated under spinal anesthesia
Foleys catheter in place
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1
2
You see all the stones over the surgeons gloved
hand. Second picture shows close up view of the
first picture.
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An artistic resident lady doctor arranged these
stones in an artistic fan shaped manner as if
they were diamonds.
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