Role of Cysto-urethroscopy in the management of congenital urethral duplication in pediatrics. A case Report

Authors

1 Pediatric Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 Urology Department, Fakous General Hospital, Egypt

3 Pediatric Surgery Department, Fakous General Hospital, Egypt

Abstract

Background: Urinary tract duplication is an extremely unusual birth defect that can impact genito-urinary system. Two urethral tracts, either partial or complete, are the hallmark of this disorder. Numerous anatomical variations have been described, with various presentations. Voiding cystourethrography and intraoperative urethroscopic evaluation are important methods for diagnosis, determining the type of duplication, and providing a standard view for surgical operations. Aim: To demonstrate the importance of cysto-urethroscopy for intraoperative evaluation of urethral duplication. Case Presentation: Here we describe a case of full urethral duplication in a child who was 4 years old. During the operation, cystourethroscopy showed that the bladder and orthotopic urethra were both normal. Distal to the bladder neck, an opening of the accessory urethra was detected. So, the duplicated urethra was excised as proximally as possible. Results: The postoperative follow-up period was uneventful, and the patient had a satisfactory cosmetic penile shape, normal urinary stream, and free postoperative cystourethrogram. Conclusion: Intraoperative urethroscopic evaluation of urethral duplication is valuable to confirm the exact position of the internal opening and proper anatomical identification. Also, meticulous and complete separation of the accessory urethra is essential to obtaining a safe procedure and good post-operative results.

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