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Prof. Dr. Ali Avanoğlu
Hypospadias Surgery • After Surgery

Urethral Diverticulum (Ballooning During Urination)

Part of the repaired channel has widened into a pouch. Urine collects there and dribbles out after urination has finished. This picture is often an early sign of a stricture further along the channel.

Who this is forPatients with swelling while urinating
Reading≈1 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
where it should beDistal penile
underside view
01 · Two typical causes02 · Why evaluate rather than simply watch it?03 · Order of treatment
In brief3 madde
  • Two typical causes: This distinction determines treatment.
  • Why evaluate rather than simply watch it?: Urine that collects can, over time, lead to infection, foul odor, and, rarely, stone formation.
  • Order of treatment: First: clearing the stricture further along the channel.
01

Two typical causes

This distinction determines treatment. In a diverticulum caused by a stricture, narrowing the pouch alone doesn't solve the problem — if the blockage isn't removed, the ballooning comes back.

  • A stricture further along the channel: urine builds up pressure behind the blockage and balloons out the weaker wall.
  • The channel having been made wider than necessary during the repair.
02

Why evaluate rather than simply watch it?

Urine that collects can, over time, lead to infection, foul odor, and, rarely, stone formation.

03

Order of treatment

  • First: clearing the stricture further along the channel.
  • Then: removing the excess tissue and bringing the channel down to the right diameter.
  • If a stone has formed in the pouch, it's cleared in the same operation.
  • If a large part of the channel is affected, that segment is reconstructed.
Hypospadias Surgery video guide19 short videos, in order
Frequently asked questions
Why does dribbling happen after urination?
Urine that has collected in the pouch drains out by gravity once urination has finished. This is the most typical sign of a diverticulum.
Prof. Dr. Ali Avanoğlu's publications on this topic · 1
  1. Tiryaki S, Ələkbərova V, Dokumcu Z, et al. (2016). Unexpected outcome of a modification of Bracka repair for proximal hypospadias: High incidence of diverticula with flaps. Journal of pediatric urology. PubMed ↗
←Previous • After SurgeryRecurrent Penile Curvature
Related pagesFull index →
After SurgeryUrethral Stricture After Hypospadias SurgeryIf the stream is weak but the opening itself doesn't look narrow, the stricture lies further inside the channel. This picture isn't solved by procedures aimed at the opening alone; the stricture's location and length need to be identified.Follow-up and AssessmentUroflowmetry and UrethrographyIn every patient with a stream problem, two questions need answers: is the stream genuinely weak, and where is the blockage? That's exactly what these two tests exist to answer.Hypospadias in AdultsHair and Stone Problems in the UrethraIf you're describing recurrent infection, odor, and a poor urinary stream, hair-bearing skin may have been used in an earlier repair. This picture typically becomes noticeable after puberty.After SurgeryFistula After Hypospadias SurgeryAn opening has formed that leaks urine between the repaired channel and the skin. This is the most common complication in hypospadias surgery, and in most cases it can be closed permanently with a small, planned procedure.
Hypospadias Surgery topic clustersMain treatment page →
Basics 8Surgery in Children 8Surgical Techniques 5After Surgery 9Recurrent Cases 4Hypospadias in Adults 8Follow-up and Assessment 5
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