An unusual presentation of Y-type urethral duplication with perianal abscess: case report

Urethral duplications are rare anomalies that manifest in various anatomic forms. These variations are classified broadly as epispadic, hypospadic, and Y-type duplications. In the Y-type, the accessory ventral channel opens into either the perineum or the anal canal. Typically, the dorsal urethra is hypoplastic, and the external meatus is stenotic, so urine is voided through the dominant ventral channel. In the other unusual form, the dorsal urethra is normal and perineal or rectal opening of accessory ventral urethra is an accidental finding. When treating patients with typical Y-type duplications, the accessory ventral urethra is mobilized and then is carried to the glans with one- or 2-stage urethroplasty. In the unusual form, excision of the anterior urethra is the definitive surgical treatment. This report describes a case of unusual Y-type urethral duplication in which the accessory ventral channel had a stenotic perianal opening. The patient developed recurrent attacks of perianal abscess associated with urinary tract infections. To the authors' knowledge, this is the first reported case of Y-type duplication with an hypoplastic accessory ventral channel that was presented with recurrent perianal abscess attacks.