Urethral duplication in children: Our experience of eight cases

Abstract 

Objective

Duplication of urethra has varied presentations and multiple techniques have been described for its correction. We present our experience in the management of this anomaly.

Material and method

We retrospectively reviewed the records of eight patients treated for urethral duplication in 1998–2008. We managed four cases of Y-duplication, three of whom underwent buccal mucosal tube urethroplasty and one urethrourethrostomy. Two patients presented with double stream (type II A2); in one urethrourethrostomy was done and the other child underwent vesicostomy as initial treatment. Two cases were of type II B duplication (two urethra opening as single meatus); one required only dilatation of urethra and the other excision of accessory tract.

Result

Mean age at presentation was 56.9 months. Associated anomaly was present in only two patients. Single-stage procedure was done in four patients and multi-staged procedure in three patients. Overall mean number of procedures required was 2.8; more were required in the case of Y-duplication compared to the other types. On follow-up all patients were passing urine in single stream.

Conclusion

Thorough work up to detect any associated anomaly and type of duplication is required for the management of urethral duplication. Single-stage repair with buccal mucosa as tube urethroplasty in cases of Y-duplication is feasible with good outcome.

Keywords: Urethral anomaly, Accessory urethra, Urethral duplication, Y-duplication