In infancy and childhood there are many causes for obstruction to the flow of urine through the urethra. These include preputial adhesions,meatal narrowing, urethral stricture, posterior urethral valves, and contracted bladder neck. It has been known also that congenital diverticula of the urethra can give rise to urinary obstruction. These have been studied by Watts1 in 1906, by Lowsley and Gutierrez2 in 1928, by Kretschmer3 in 1936, and by Campbell4 in 1937. Such diverticula have been detected heretofore by the presence of a swelling on the ventral surface of the penis, in the peno-scrotal angle, or in the perineum. It is the purpose of this paper to present three cases of concealed diverticula of the urethra in each of which there was urinary obstruction; in none of these was there any swelling on the external surface of the penis. In two of these children the cause of obstruction was not recognized during life;death ensued as a result of urinary tract infection and the urethral abnormalities were found at autopsy. In the third child the cause of obstruction was found by roentgenologic visualization of the urethra, and surgical relief of the obstruction was prompdy instituted.
CASE REPORTS
Case 1
Children's Hospital #153,603. This 5-year-old boy was admitted to the Surgical Service on October 3, 1931, with a history of urinary dribbling,intermittent fever, and pyuria. The mother stated that until 1½ years of age, the child had had no urinary stream, the urine coming away only in a slow
Discussion on Lower Urinary Obstruction
