Congenital megalourethra with delayed obstructive symptoms

Congenital megalourethra is a congenital non-obstructive dilation of the male urethra often associated with VACTERL anomaly malformations. We report a case of TE fistula associated congenital megalourethra with symptoms presenting approximately 2 months postpartum. At the time of referral, patient had distal penile flaccidity and poorly developed corpora. Imaging and cystoscopy showed development of hydronephrosis with significant sediment in the bladder. Attempts at retrograde catheterization failed, thus a Blocksum vesicostomy was required. This demonstrates the importance of serial physical examinations and ultrasound surveillance in patients with megalourethra.