Abstract

A 66-year-old man, who underwent urethral reconstruction using skin grafts for hypospadias five decades earlier as a 13-year-old child, presented with burning micturition and recurrent UTI. A retrograde urethrogram along with micturating cystourethrogram revealed a bulbar urethral stricture and broad neck distal penile urethral diverticulum. On a cystourethroscopic examination, a urethral diverticulum was seen just proximal to the hypospadiac external urethral meatus with 12–15 hair follicles inside the diverticulum and a 1 cm long mid-bulbar stricture. Visual internal urethrotomy for the bulbar stricture, a diverticular neck incision, laser epilation and hair follicle photocoagulation was performed using a 30 W Ho:YAG laser. The depilated hair tufts were extracted. The process was repeated again in 6 months due to recurrent symptoms. A patent urethra with a wide open diverticulum without any residual hair follicles was confirmed. No perioperative complications noted and the patient is doing well on 1 month of follow-up.