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[Urethral duplication in pediatric age. A case report].

B Abbate1, N Centonze, D A Danti

  • 1Dipartimento di Chirurgia Pediatrica, Azienda Ospedalier Anna Meyer, Via L. Giordano no. 13, 50137 Firenze.

La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|December 24, 2002
PubMed
Summary

Urethral duplication is a rare congenital anomaly. Surgical excision of the accessory urethra is effective for symptomatic cases, offering a good prognosis.

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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:

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  • 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.