Double urethra

• 04 Mar 2020 11:15:25 AM
• |General Urology

This 28 yrs old male presented to us with dysuria of 3 days duration.

Comments(7)

• 

  Gyanendra Sharma

  04 Mar 2020 12:14:54 PM

  Dear Dr. Mazumdar

  I feel the information is inadequate to make a diagnosis of double urethra (duplication of Urethra)

  You can get this appearance even in cases where the distal opening ends in a blind pit & the proximal opening is the normal urethra

  As regards your question as to have to investigate--Ascending urethrogram would be the first choice followed by MCU in cases where a duplication of urethra is present

• 

  Tikenjit Mazumdar

  04 Mar 2020 01:18:40 PM

  Yes sir....ift passing through one hole upto bladder drain urine..

  Other is blind...

  Patient lost to follow up..

  Sorry for incomplete information sir.

• 

  Amilal Bhat

  05 Mar 2020 10:07:09 AM

  These cases are incomplete duplication ,Usually distal 1-2 cm dorsal urethra ,can be checked by passing a infant feeding tube during OPD examination itself. dorsal urethra may be combined with urethral plate by incising it ventrally and then tubularize the urethral plate.

  Amilal bhat

• 

  Tikenjit Mazumdar

  05 Mar 2020 12:38:56 PM

  Thank u sir

• 

  Uday Sankar Chatterjee

  05 Mar 2020 05:38:16 PM

  In cases of Double urethra, most of the situation, ectopic is of good calibre and orthotopic is narrower. 

  
  

  For cosmesis, orthotopic to be restored in good calibre by urethro-urethral side to side anastomosis upto 'Y' junction; and excision of ectopic meatus (cosmesis)

• 

  Venugopal P

  08 Mar 2020 11:13:29 AM

  Dear All,

  Urethral duplication has been discussed earlier as well but not in Uroacademy. I am not entering into the realms of Urethral Duplication but have decided to skirt around it with anomalies close to it. However to make a beginning, one will have to understand the famous Effmann’s classification (1976) based on detailed radiological anatomy as seen in the patients’ urethrograms and is popular among Urologists and Radiologists. I am providing this classification as a PDF attachment.

  In 2015, Amr AbdelHamid AbouZeid* et al suggested a modified from the various older Classifications.

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372522/pdf/10.1177_1756287214561760.pdf

  This classification depends on the orientation of the double urethral channels. The double Urethra was first classified into either sagittal type (one urethra above other) or Collateral Type (Lying side by side). The Collateral type represents a part of partial or complete caudal duplication; while in the sagittal type, the dorsal urethral channel was always the accessory one.

  There is another congenital anomaly which is not discussed usually due to its rarity. This is ‘Prepubic Sinus’.

  FD Stephens (1983) when discussing ‘Abnormal embryology-cloacal dysgenesis’ gave the classification for this entity.

  Stephens described 3 types of dorsal urethral duplication according to the anatomy.

  Type 1 is a complete or incomplete tandem channel that runs parallel to the normal urethra from the glans to the bladder, which joins the urethra or ends blindly.

  Type 2 is an epispadiac type of channel from the dorsum of the penis to the bladder or one that joins the urethra at some point.

  Type 3 is a dermoid sinus that simulates an accessory urethra but tracks from the base of the penis in front of the pelvic urethra and bladder behind the pubic symphysis to or towards the umbilicus.

  Another area not commonly discussed but observed when performing Cystoscopy is the presence or absence of Lacuna Magna. Sunil Shenoy et al (2011) published an article addressing ‘An Endoscopic Study of the Lacuna Magna and Reappraisal of Its Clinical Significance’ which is worth understanding by all. I am providing the article as a PDF attachment for your reading.

  I am sure these informations provided will enhance our overall knowledge

  With warm Regards,

  Venu

   

  View Document

• 

  Venugopal P

  08 Mar 2020 11:14:55 AM

  Effmann's Classification Urethral Duplication

  View Document