Urethral duplication in children: Surgical treatment and results

被引:45
作者
Podesta, ML [1 ]
Medel, R
Castera, R
Ruarte, AC
机构
[1] Hosp Ninos Dr Ricardo Gutierrez, Dept Surg, Urol Unit, Buenos Aires, DF, Argentina
[2] Univ Buenos Aires, Associated Hosp, Buenos Aires, DF, Argentina
关键词
urethra; abnormalities; hypospadias;
D O I
10.1016/S0022-5347(01)62427-3
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Urethral duplication is a rare congenital anomaly. We report the clinical presentation, imaging findings and surgical treatment in 7 boys with incomplete sagittal duplication of the urethra. Materials and Methods: Duplication involved hypospadias in 5 cases (group 1) and a bifid urethra with an accessory preanal tract (Y duplication) in 2 (group 2). Group 1 was treated with 1-stage urethroplasty, including marsupialization of the dorsal orthotopic urethra, ventral-to-dorsal urethrourethrostomy and penile island flap onlay repair to cover the open dorsal urethra. In contrast, group 2 was treated with 2-stage urethral reconstruction with detachment and mobilization of the accessory preanal branch in association with a scrotal tubed neourethra followed by urethroplasty, as in group 1. In all cases the dorsal penile urethra was located between the corpora cavernosa and surrounded by the tunica albuginea. Results: A urethrocutaneous fistula developed in 1 of the 5 group 1 patients. In group 2, 1 patient had recurrent penoscrotal meatal stenosis after the 1-stage procedure and 1 had a urethral diverticulum with calculi at the scrotal tubed neourethra 7 yea's after urethral reconstruction. Six of the 7 patients now void spontaneously through a meatus located normally at the tip of the glans. The remaining patient with a neurogenic bladder is on intermittent catheterization via appendicovesicostomy due to difficult catheterization of the irregular and sensitive neourethra. Conclusions: While the ideal surgical management of urethral duplication anomalies remains uncertain, we used a combination of surgical techniques to correct this severe malformation.
引用
收藏
页码:1830 / 1833
页数:4
相关论文
共 19 条
[1]   CONGENITAL URETHROPERINEAL FISTULA [J].
BATES, DG ;
LEBOWITZ, RL .
RADIOLOGY, 1995, 194 (02) :501-504
[2]   REPAIR OF A CONGENITAL H-TYPE URETHRORECTAL FISTULA USING A SCROTAL FLAP URETHROPLASTY [J].
BELMAN, AB .
JOURNAL OF UROLOGY, 1977, 118 (04) :659-661
[3]  
DAS S, 1977, J UROLOGY, V117, P452, DOI 10.1016/S0022-5347(17)58496-7
[4]   CONGENITAL H-TYPE ANO-URETHRAL FISTULA [J].
DEVRIES, PA ;
FRIEDLAND, GW .
RADIOLOGY, 1974, 113 (02) :397-407
[5]   DUPLICATION OF URETHRA [J].
EFFMANN, EL ;
LEBOWITZ, RL ;
COLODNY, AH .
RADIOLOGY, 1976, 119 (01) :179-185
[6]   VESICOPERINEAL ACCESSORY URETHRA [J].
GLASSBERG, KI ;
SCHWARZ, R ;
HALLER, JO .
JOURNAL OF UROLOGY, 1978, 120 (02) :255-256
[7]   FULGURATION-ABLATION OF ATYPICAL ACCESSORY URETHRA [J].
HOLST, S ;
PETERSON, NE .
JOURNAL OF UROLOGY, 1988, 140 (02) :347-348
[8]  
JORDAN GH, 1988, CLIN PLAST SURG, V15, P493
[9]  
JORDAN GH, 1986, J UROL 2, pA212
[10]   URETHRAL DUPLICATION [J].
ORTOLANO, V ;
NASRALLAH, PF .
JOURNAL OF UROLOGY, 1986, 136 (04) :909-912