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@wilnetonline.net

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.

A case of prolapse uterus and not of divertculum as 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

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.

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

You see all the stones over the surgeon’s gloved hand. 1 2 You see all the stones over the surgeon’s gloved hand. Second picture shows close up view of the first picture.

An artistic resident lady doctor arranged these stones in an artistic fan shaped manner, as if they were diamonds.

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