Urethral duplication - A wide spectrum of anomalies

被引:28
作者
Onofre, Luciano Silveira [1 ]
Gomes, Adriano Luis [1 ]
de Souza Leao, Jovelino Quintino [1 ]
Leao, Fernanda Ghilardi [1 ]
Amaral Cruz, Tayane Magalhaes [1 ]
Carnevale, Jose [1 ]
机构
[1] Hosp Infantil Darcy Vargas, Pediat Urol Div, Sao Paulo, Brazil
关键词
Urethra; Abnormalities; Urethral duplication; Surgical approach; CONGENITAL PREPUBIC SINUS; BLADDER EXSTROPHY; CHILDREN; PLANE;
D O I
10.1016/j.jpurol.2013.03.006
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: Urethral duplications are rare lower urinary tract anomalies, with multiple anatomical variants described. This paper aims to separate this complex anomaly into different diseases, each with distinct clinical forms according to the disturbance during embryogenesis, yet noting a few similarities that may be helpful in their management. The classification system of urethral duplication is also discussed. Material and methods: Twelve urethral duplication cases over a 14-year period were reviewed. Clinical presentation, the imaging studies used to ascertain anatomical details, type of urethral duplication and surgical correction used in the treatment of patients are presented. Results: Nine patients had urethral duplication in the sagittal plane and three patients in the coronal plane. Of the patients with sagittal urethral duplication, 3 had pre pubic sinus, 3 had epispadiac urethral duplication, 1 had a dorsal urethral duplication deviated from the midline and 2 had hypospadiac urethral duplication. All the patients with coronal urethral duplication had associated bladder duplication. The surgical correction of the patients with sagittal urethral duplication included excision of the pre pubic sinus, excision of the duplicated urethra, and urethroplasty. Excision of the hemibladders' septum and closure of one bladder neck was the treatment for patients with coronal urethral duplication and bladder duplication. Conclusion: Urethral duplication is a complex anomaly and the different manifestations probably have different embryological origins. Each group, sagittal or coronal, has a few similarities that may be helpful in their management, although every diagnosed case presents a unique anatomy and surgical treatment must be individualized. (C) 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1064 / 1071
页数:8
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