A 16-year-old African male presented to the urology department with recurrent urinary tract infections and a burning sensation during urination. His medical history was unremarkable. Vital signs showed fever, while the others were within normal range. Physical examination revealed pus-like discharge from the urethral and swelling on the ventral of the bulbar urethral, which was rigid, well-defined, and non-compressible. Complete Blood Count (CBC) were within normal range. Urinalysis showed the presence of blood in the urine (hematuria) and pus (pyuria). Echography was performed, revealing a large stone with acoustic shadowing in the ventral aspect of the bulbar urethral. Retrograde urethrogram (RUG) illustrated a large, well-defined, and round cystic lesion on the ventral aspect of the bulbar urethral (Fig. 1). Following this examination, the patient was diagnosed with a congenital UD, attributed to the absence of a history of urethral surgery or trauma. Under general anesthesia, the patient underwent urethral diverticulectomy. An incision was made on the ventral bulbar penis, followed by the dissection of the skin and corpus spongiosum. When the diverticulum became visible, its wall was dissected from the urethral, the stone (which is believed to be of calcium oxalate origin, given its rigid nature) was removed, and a diverticulectomy was performed (Fig. 2). Subsequently, urethral anastomosis was conducted, and a Buck’s fascia was placed. After that, the corpus spongiosum and skin were sutured. A Foley catheter was inserted after the surgery, and after 10 days, no complications were reported—the foley catheter was removed and the patient was discharged in good health.

Retrograde urethrogram revealed a large, well-defined, and round cystic lesion on the ventral aspect of the bulbar urethral

Intraoperative view. (A): observation of diverticulum and stone. (B): Stone removal and diverticulectomy procedure. (C): Measurement of the removed stone