Summary
Introduction
Duplication of the urethra is a rare congenital anomaly in females which, if left
unidentified, might cause refractory urinary incontinence. This video demonstrates
its identification and treatment.
Patient & methods
A 5-year-old female was referred for primary refractory diurnal incontinence without
any dry moment since birth. Initial clinical examination showed permanent urine leakage
from an opening cranial to the clitoris. Ultrasound did not show any bladder or kidney
abnormalities. A diagnostic cystoscopy under anesthesia revealed an accessory meatus
located cranially to the orthotopic meatus and to the clitoris.
Results
Lying in dorsal decubitus under general anesthesia, catheters were inserted in respectively
the orthotopic and accessory meatus. The accessory meatus and urethra were dissected
away into the bladder dome from a circumferential skin incision. Defects were closed
and bladder drainage per urethram was left in situ for 10 days. P ostoperative recovery
was uncomplicated. Complete resolution of the incontinence was immediately achieved
at catheter removal. Daytime and night-time continence are observed with 3 years follow-up.
Conclusion
Urethral duplication is a rare finding in females but should be excluded during the
workup of primary incontinence. In girls with isolated urethral duplication, resection
of the accessory urethra is the best surgical option.
Keywords
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References
- Working classification and the quest for an effective, reconstructive management strategy in Y duplication of male urethra.J Pediatr Urol. 2021; 17
- Urethral duplication in girls: three cases associating an accessory epispadiac urethra and a main hypospadiac urethra.J Pediatr Urol. 2016; 12
- Urethral duplication - a wide spectrum of anomalies.J Pediatr Urol. 2013; 9 (PART B)
Article info
Publication history
Published online: August 19, 2022
Accepted:
August 15,
2022
Received in revised form:
July 19,
2022
Received:
May 9,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
