A lesson in misdiagnosis and multimodal diagnostic strategy for male urethral diverticulum with calculi: A case report

Male urethral diverticulum combined with stones is clinically rare, with diverse symptoms that lack specificity, making it easily confused with common diseases such as urethral stones. Imaging examination, especially computed tomography (CT) alone, may lead to misdiagnosis. This report describes the case of a 62-year-old male with a urethral diverticulum complicated by stone formation. The patient presented with penile root pain. An initial CT scan at an outside hospital was misinterpreted as indicating a urethral stone, but subsequent urethroscopy revealed no stone. The diagnosis of a urethral diverticulum containing a stone was confirmed by retrograde urethrography and cystoscopy. The patient underwent open surgical diverticulotomy with stone extraction and repair of the urethral fistula, using a grid-pattern suturing technique. Postoperative recovery was uneventful with normal voiding. This case highlights the importance of a multimodal diagnostic approach, including retrograde urethrography, for atypical presentations to avoid misdiagnosis, and demonstrates that meticulous surgical technique facilitates watertight urethral reconstruction.