Management of type Y urethral duplication in children: 13 cases report

Abstract

Objective To improve the diagnosis and management of type Y urethral duplication in children. Methods A total of 13 boys of type Y urethral duplication were recruited from 2005 to 2015.Their average presentation age was 5.5 (1-15) years.The major symptom was urination from perineum or anus.Four cases were complicated by chordee penis with insignificant dorsal deviated penis.Examinations included voiding cystourethrogram (VCUG), intravenous pyelography (IVP) and ultrasound for confirming other malformations.And 11 patients underwent 2-stage repair.Urethra was displaced from anal canal to perineum during initial surgery and urethral reconstruction during re-operation.One case of dysplasic ventral urethra was excised.And functional ventral urethra was excised in another patient of urethral perineum fistula. Results The follow-up period was 1 to 5 years.Four patients were successfully cured after 2-stage urethroplasty.Among 5 cases of urethral fistula, repair (n=4) and observation (n=1) were implemented.Urethral stricture developed in 2 cases of dilatation and internal urethrotomy.One case of excised ventral dysplasia urethra had excellent voiding while another case of excised functional urethra required dilatation every 2 weeks. Conclusions Prior to re-operation, it is essential to confirm functional urethra.Generally ventral urethra is the most functional and pedicle island flap urethroplasty is recommended. Key words: Urethral duplication; Voiding cystourethrography; Treatment outcome