Multiple urethral anomalies: Anterior urethral diverticulum, posterior urethral valves, and distal hypospadias

We report an infant with antenatally detected bilateral hydroureteronephrosis and a penile cyst who was eventually diagnosed with an anterior urethral diverticulum (AUD), subcoronal hypospadias, and posterior urethral valves (PUV) after birth. To our knowledge, there are no reports where all three anomalies have been found to coexist. As per urethral catheterisation was difficult, cystoscopy-guided catheterisation was performed. On retracting the complete foreskin, a subcoronal hypospadias was identified. The AUD was resected partially, and during a cystoscopy for completion of AUD resection, a dilated anterior urethra was found collapsed, and thin PUV were identified and divided. He remains well at nine months with an improving renal cortical thickness. The vesicoureteric reflux had resolved.