Abstract
ABSTRACTIntroduction:Urethral duplication is rare. Characterized by the presence of two urethral channels. This anomaly presents a great variety of clinical findings that depend on the type of duplication that often is associated with other anomalies.Material and Methods:We report thirteen boys with urethral duplication managed in our institution between 1988-2015. Clinical findings, associated anomalies, treatment of urethral duplication and our results are described. Patients were classified according to Effmann classification.Results:Mean patient's age was 38.3±34.7 months (3-136 months). Mean follow-up was 7.7±3.4 years (3y8m-14y2m). Type II A2 was the most common pattern (8/13 patients, 61.5%), followed by type IA (3/13 patients, 23%) and IIA1 (2/13 patients, 15.3%). The most frequent clinical manifestations were urinary tract infections (UTI) observed in 11/13 patients (84.6%) and anal urinary leakage, found in 7/13 patients (53.8%). Associated anomalies were found in 9/13 patients (69.2%).Required surgeries were 3.53±2.84 procedures per patient. Considering groups: Type IIA2 4.25±3.28, type IIA1 4±1.41 and type IA 1.33±0.57 needed procedures per patient. Complications rate were 0% for type IA, 50% for type IIA1 and 75% for type IIA2.Conclusions:Patients with incomplete duplication (type I A or I B) can totally be asymptomatic, with no need of surgical correction. Type IIA2 is the most complex form of duplication to correct and multiple procedures might be required because of the very hypoplastic orthotopic dorsal urethral tissue. Surgical treatment should be individualized and parents should be advised on complications and need of multiple surgeries according to urethral duplication type.
Highlights
IntroductionCharacterized by the presence of two urethral channels
Urethral duplication is a rare congenital anomaly characterized by two urethral channels, whose location and extension present variations
We searched in our hospital database for urethral duplication cases submitted to surgical treatment
Summary
Characterized by the presence of two urethral channels This anomaly presents a great variety of clinical findings that depend on the type of duplication that often is associated with other anomalies. Urethral duplication is a rare congenital anomaly characterized by two urethral channels, whose location and extension present variations It is more common in males, occurring usually in the sagittal plane. Patients can be either asymptomatic or symptomatic, most common clinical findings being incontinence, obstruction, recurrent urinary ibju | Treatement of urethral duplication infection, and occasionally double urinary stream [1,2,3,4]. The objective of this study was to review our experience in the management of urethral duplication anomalies and to determine whether the type of urethral duplication influences on the number of surgical procedures needed for repair and complication rates
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