Clinical case of urethral doubling with preservation of function and single bladder

Abstract

Urethral doubling is a rare congenital anomaly of the urinary system that is more common in boys. Less than 500 clinical cases of this disease have been described in the literature, which may signal a lack of awareness among physicians. Although there are many considerations regarding the embryology of this anomaly, the etiopathogenesis of its various forms remains unclear. Sometimes doubling of the urethra is combined with other malformations, such as epispadias, hypospadias, exstrophy of the bladder, anorectal malformation, doubling of the bladder and others. In this article, we present a clinical case of a 9-year-old boy with urethral duplication and additional urethral epispadias. We found the main and additional urethra, which goes on dorsal side of the penis and led to curvature of the penis and urinary incontinence. During the operation, urethrocystoscopy was performed before the main stage, and a complete doubling of the type 2-A urethra was established according to the Effman classification, after which the additional urethra was excised as far as the pubic bones. Urethral duplication is a rare anomaly, with several forms of clinical presentation, often accompanied by other anomalies, and sometimes with difficult diagnosis. The treatment of urethral duplication should be individualized, according to its type. In this case we find urethral duplication type IIa, which has been treated as classic epispadias. Therefore, in child with congenital malformation of penis need to perform obsrvetion like urethrography, cystoscopy. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: urethral substitution, epispadias.