Related Experiment Video
Updated: Mar 11, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Practical and functional classification of the double urethra: A variable, complex and fascinating malformation
1Department of Pediatric Surgery, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Introduction:
Urethral duplication is a rare and variable malformation of the urinary tract, with non-univocal and complex management. In addition, different classification schemes have been proposed, but none have considered all the possible variants.
Objective:
To report experience with the management of 20 urethral duplication patients and propose a classification of this anomaly.
Materials And Methods:
A retrospective analysis collecting information regarding 20 patients (Table) with urethral duplication treated at a single institution over the past 40 years. Three females and 17 males were treated: two had vesico-urethral duplication, eight had urethral duplication with a single bladder, and eight had 'λ' duplication.
Results:
Immediate postoperative complications included urethral dehiescence (n = 1) and urethral stenosis (n = 2). The progressive augmentation by dilating the urethra (PADUA) technique was ineffective. During follow-up, the following were recorded: urinary incontinence (n = 2), urinary tract infection (n = 3), hypertension (n = 3) and erectile dysfunction (n = 1). All patients were satisfied with the aesthetic result.
Discussion:
Urethral duplication is a rare anomaly with male preponderance. Four types of duplication were described, on the basis of anatomy and management: vesical and urethral duplication (type 1), urethral duplication with single bladder (type 2), 'λ-type' duplication (type 3) and 'miscellanea' (multiple urethral channels, spindle urethra, other female forms, type 4). A full description of the malformation and surgical approach was given for each type. The advantages of the classification were compared with the literature.
Conclusions:
The proposed classification should be a useful tool, based on the required surgical approach, even if surgery should be tailored to the patient. It is important to restore the anatomy and achieve urinary continence. Surgery can be challenging and a multi-step process, especially in cases of 'λ' duplications.
More Related Videos
03:55Urethroplasty with Pedicled Tunica Vaginalis for the Treatment of Long-segment Anterior Urethral Stricture Caused by Lichen Sclerosus of Glans Penis
Published on: October 18, 2024
06:05Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
Related Concept Videos
01:16Urethra
The anatomy of the urethra differs between males and females. In females, the urethra is short, measuring about 3–4 cm in length, and opens anterior to the vaginal opening. In males, the urethra is longer and passes through the penis, serving dual purposes: expelling urine and ejaculating semen. The male...
01:19Anatomy of the Genitourinary System II: Bladder and Urethra
01:22Ureters
01:23Urinary Bladder
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
01:11Anatomy of the Genitourinary System I: Kidneys and Ureters
01:26Urinary Tract Infection I: Introduction