Staged repair of Effmann type IIA2Y urethral duplication using composite tissue tubularization: A case report

Effmann type IIA2Y urethral duplication is a rare congenital anomaly requiring individualized surgical management. We report a pediatric case managed with initial buccal mucosa grafting and perineal urethrostomy, followed by a 9-year loss to follow-up. On return, the graft remained viable, and definitive repair was performed using composite tissue tubularization with buccal mucosa, perineal, and scrotal skin. The patient achieved continent, complication-free voiding. This case highlights the durability of multi-tissue grafts and demonstrates the feasibility of delayed reconstruction in complex urethral anomalies.