Visual urethrotomy in management of male urethral duplication

Anatomically, three types of urethral duplication have been described: Type I or complete urethral duplication, Type II which includes multiple variations of bifid urethra, and Type III, those urethral duplications with a perineal opening. A new, simplified approach to the management of some Type II urethral duplications is described, using the pediatric cold-knife visual urethrotome. This technique provides a maximally patent urethra, while removing the site of chronic refractory infection, and minimizing both morbidity and patient hospitalization. Alternatives for treatment of Type I and Type III urethral duplications also are discussed.