Late-presenting congenital anterior urethral diverticulum causing renal impairment in a male child

Abstract

We report the case of a 6-year-old boy who presented with lower urinary tract obstruction and chronic renal impairment due to a delayed diagnosis of isolated CAUD. The diagnosis was eventually made by voiding cystourethrography, which revealed a large anterior diverticulum. This case illustrates a rare late presentation of CAUD with significant renal dysfunction, highlighting a crucial diagnostic pitfall. Clinicians should actively consider and investigate for anterior urethral diverticulum in any male child presenting with unexplained renal insufficiency or voiding symptoms, as early detection is essential to prevent irreversible upper urinary tract damage. • This case highlights rare CAUD beyond infancy, causing upper tract issues and showing the risks of delayed recognition. • It underlines diagnostic and treatment challenges, stressing the value of early surgical care to protect kidney function. • The case adds insights for pediatric teams and supports the journal’s aim to advance knowledge in pediatric urology.