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Urethral Duplication

Duplicate epispadic urethra:

A duplicate epispadic urethra is an additional dorsal urethra, running retropubically and either completely or incompletely. A complete epispadic duplicate urethra causes incontinence due to the absence of a sphincter. For incomplete duplication, the urethras meet, and a double stream with continence results, or the epispadic urethra ends blind (Salle et al., 2000).

Duplicate hypospadic urethra:

A duplicate hypospadic urethra is an additional ventral urethra, complete or incomplete. A wide range of anatomic forms exists, from short blind-ending defects to additional urethras opening at the perineum (CUPF: congenital urethro-perineal fistula) or into the anus.

Duplicate lateral urethra:

A duplicate lateral urethra is usually accompanied by duplication of the external genitalia, often with anal atresia or symphysis diastasis.

Diagnosis of Urethral Duplication:

Retrograde urethrography, voiding cystourethrogram, cystoscopy, pelvic MRI, depending on additional malformations.

Treatment of Urethral Duplication

A small, blind-ending, and asymptomatic urethral duplication is not treated, or superficial endoscopic coagulation of the mucosa is done for scarring and closure. In other cases, surgery is often complex and may require multiple-stage repairs.

References

Salle, J. L.; Sibai, H.; Rosenstein, D.; Brzezinski, A. E. & Corcos, J. Urethral duplication in the male: review of 16 cases.
J Urol, 2000, 163, 1936-1940

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