[Urethral duplication in pediatric age. A case report]

Area of Science:

• Urology
• Pediatric Surgery
• Congenital Anomalies

Background:

• Urethral duplication is a rare congenital anomaly stemming from urogenital sinus malformations.
• It typically develops on the sagittal plane, with accessory urethras positioned dorsally (epispadic) or ventrally (hypospadic) to the orthotopic urethra.
• Approximately 150 cases are reported, predominantly in males, and often associated with other genitourinary or systemic malformations.

Observation:

• A case report details a 4-year-old male with complete epispadic urethral duplication presenting with two meatuses.
• Clinical symptoms included a weakened urinary stream, incontinence, and recurrent urinary tract infections (UTIs).
• Imaging revealed a normally functioning upper urinary tract and bladder, with a fully patent duplicated urethra.

Findings:

• Surgical excision of the accessory urethra and hypospadic meatus reconstruction using an overlap anastomosis was performed.
• The postoperative period was uneventful, with the patient remaining asymptomatic one year post-surgery.
• Postoperative assessments confirmed normal uroflowmetry and complete bladder emptying.

Implications:

• Surgical intervention is indicated for symptomatic urethral duplication.
• Treatment strategies should be tailored to the specific malformation type, severity, clinical presentation, and associated anomalies.
• Non-surgical treatments like antibiotics, diathermocoagulation, or caustic injections are ineffective and have been abandoned.