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Urethral Triplication Without Bladder Duplication: Endourologic Diagnosis and Management.

Alberto Parente1, Ruben Ortiz1, Laura Burgos1

  • 1Department of Pediatric Urology, Gregorio Marañon University Hospital, Madrid, Spain.

Journal of Endourology Case Reports
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Summary

Urethral triplication, a rare congenital anomaly, involves a boy with an extra urethra. This case presents a unique instance of two common urethral duplication types within a single patient, highlighting diagnostic complexity.

Keywords:
childrentriplicationurethralurethral duplication

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Congenital Anomalies

Background:

  • Urethral triplication is an exceptionally rare congenital anomaly of the lower urinary tract.
  • Fewer than 15 cases have been documented in medical literature.

Observation:

  • A 24-month-old boy presented with an accessory hypoplastic urethra terminating at the glans.
  • During toilet training, fecaluria (urine in stool) was noted, indicating a potential rectourethral connection.
  • Diagnostic cystoscopy revealed a complex anatomical abnormality involving multiple urethral pathways.

Findings:

  • Rigid cystoscopy identified a perineal urethra originating from the posterior urethra.
  • Flexible cystoscopy demonstrated an epispadic urethra entering the bladder superior to the bladder neck, running parallel to the primary urethra.
  • This patient exhibited features of two common urethral duplication patterns within a single occurrence.

Implications:

  • This case expands the understanding of urethral anomalies and their varied presentations.
  • It underscores the importance of thorough diagnostic evaluation in complex genitourinary abnormalities.
  • Further research into the embryological origins and management strategies for such rare conditions is warranted.