1. 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 (Gujarat) INDIA
T.N.(079) , Mobile;
E mail:-

2. 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.

3. 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

4. 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.

5. 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

6. 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.

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

8. THANK YOU