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Urethral duplication with unusual cause of bladder outlet obstruction
Vivek Venkatramani1, Arun Jacob Philip George1, J Chandrasingh1
1Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
Summary
A 12-year-old boy with recurrent urinary tract infections and poor urinary flow was diagnosed with urethral duplication. Surgical correction via urethro-urethrostomy successfully resolved his symptoms.
Area of Science:
- Pediatric Urology
- Genitourinary Surgery
- Congenital Anomalies
Background:
- Hypospadias repair in childhood can rarely lead to complex urethral anomalies.
- Recurrent urinary tract infections and poor urinary flow are significant indicators of underlying genitourinary pathology.
Observation:
- A 12-year-old male presented with symptoms secondary to a complex urethral anomaly post-hypospadias repair.
- Imaging revealed urethral duplication with a hypoplastic dorsal urethra and a patent ventral urethra, alongside bladder neck duplication.
Findings:
- Voiding cystourethrogram demonstrated a hypoplastic ventral bladder neck compressed by the dorsal component during micturition.
- Functional obstruction of the ventral urethra was suspected due to the occluded dorsal urethra.
Implications:
- Successful urethro-urethrostomy offers a viable treatment for complex urethral duplication causing functional obstruction.
- This case highlights the importance of thorough evaluation for persistent voiding dysfunction after hypospadias surgery.
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