Summary
Background
Management of urethral and bladder duplication anomalies centers on prevention of
recurrent infections and preservation of renal function. We present a surgical approach
to urethral triplication and bladder duplication utilizing a combined robotic and
open approach.
Methods
A 17-year-old male presenting with fevers and abdominal pain was found to have two
accessory urethras dorsal to a normal orthotopic ventral meatus. A large cavity anterior
to the bladder was identified on a computed tomography scan and drained of purulent
fluid. After improvement with antibiotics, endoscopic evaluation revealed no distinct
connection between the cavities. The patient subsequently underwent open excision
of the urethral triplication followed by robotic excision of the accessory bladder.
Results
Total console time for the robotic portion was 2 hours 18 minutes and estimated blood
loss was 30 mL. The dissection was difficult due to reaction from prior infections, but the accessory
bladder was able to be dissected off without opening the native bladder. The accessory
bladder specimen was consistent with a urothelial lining exhibiting reactive changes.
Conclusion
To our knowledge, robotic excision of a urethral/bladder duplication anomaly has not
yet been described in the literature. The robotic approach allowed for excellent visualization
and is technically feasible.
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References
- Urethral duplication – a wide spectrum of anomalies.J Pediatr Urol. 2013; 9: 1064-1071
- Congenital prepubic sinus: a variant of dorsal urethral duplication suggested by immunohistochemical analysis.J Urol. 2001; 166: 1876-1879
- Wein A.J. Kavoussi Novick A.C. Partin A.W. Peters C.A. Bladder anomalies in children. Campbell-walsh urology. 10th ed. Saunders, Philadelphia, PA2011: 3385-3386 (2012)
- Complete urethral duplication: description of surgical approach mimicking distal epispadias repair.J Pediatr Urol. 2012; 8: 343-347
Article info
Publication history
Published online: February 05, 2015
Accepted:
November 12,
2014
Received:
November 11,
2014
Identification
Copyright
© 2015 Journal of Pediatric Urology Company. Published by Elsevier Inc. All rights reserved.
