Pendulous Penile diverticulum

[firewicket]

I have a patient who has a pendulous penile diverticulum that is about 1cm in size and distends when he urinates. He had a hypospadias correction when he was an infant. If there are no symptoms from this findings do they need to have it corrected?

What are the chances it continues to grow/stays asymptomatic.

Does anyone have experience with patients who have asymptomatic pendulous penile diverticulum?

There is very little literature I could find on researching this condition.

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[armybound]

no hematuria, pain, stones, UTIs, or a fistula?

how old is the patient?

 

[firewicket]

He is 2 years old

 

[armybound]

I would have him re-evaluated by a pediatric urologist. Though he's asymptomatic and may be able to go the rest of his life without it being fixed or causing problems, if he is going to have it fixed it's easy to do when he's still in diapers.

 

[DoctwoB]

I would have him re-evaluated by a pediatric urologist. Though he's asymptomatic and may be able to go the rest of his life without it being fixed or causing problems, if he is going to have it fixed it's easy to do when he's still in diapers.

It’s an interesting issue, as the likelihood of developing a UC fistula or worsening diverticulum with subsequent infection, stones, post void dribbling, etc seems high. Given that, fixing it earlier rather than later may be the way to go given it will be lower morbidity at this age, even if currently asymptomatic.

Definitely second the need for peds Uro evaluation though.

 

[cpants]

Also, the development of a diverticulum can mean that he has a stricture of some kind downstream. Asyptomatic in a 2 year old is not that meaningful. He probably needs at the minimum a VCUG or cystoscopy to assess the anatomy and a careful eval by a pediatric urologist.