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Urethral obstruction from Cobb's collar in association with VACTERL
S Irusen1, G Moonsamy1, P Dewan2
1Division of Paediatric Nephrology, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|December 10, 2021
Summary
Cobb's collar, a rare cause of urethral obstruction, is described with VACTERL syndrome. Endoscopic treatment improved associated vesicoureteric reflux.
Area of Science:
- Pediatric Urology
- Congenital Abnormalities
- Genitourinary Surgery
Background:
- Cobb's collar is a rare intraluminal congenital anomaly causing bulbar urethral obstruction.
- It is often misdiagnosed as congenital obstructive posterior urethral membrane (COPUM).
- Distinguishing features include the absence of folds connecting to the verumontanum.
Purpose of the Study:
- To report the first association of Cobb's collar with VACTERL syndrome.
- To highlight diagnostic and therapeutic endoscopic approaches.
- To document the impact of treatment on associated vesicoureteric reflux.
Main Methods:
- Endoscopic evaluation for diagnosis.
- Diathermy and dilatation for treatment.
- Micturating cystourethrogram and renal ultrasound for follow-up.
Main Results:
- Cobb's collar was identified in association with VACTERL syndrome.
- Endoscopic diathermy and dilatation successfully treated the obstruction.
- Post-treatment evaluation showed improvement in vesicoureteric reflux.
Conclusions:
- Cobb's collar is a distinct entity from COPUM, identifiable endoscopically.
- This case represents the first documented instance of Cobb's collar co-occurring with VACTERL syndrome.
- Successful endoscopic management of Cobb's collar can resolve associated urinary tract issues like reflux.
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