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Urethral duplication in male children: A study of 12 cases

Authors
 Sung Ku Kang  ;  Jinu Kim  ;  Yong Seung Lee  ;  Sang Won Han  ;  Sang Woon Kim 
Citation
 JOURNAL OF PEDIATRIC SURGERY, Vol.55(10) : 2216-2220, 2020-10 
Journal Title
 JOURNAL OF PEDIATRIC SURGERY 
ISSN
 0022-3468 
Issue Date
2020-10
Keywords
Accessory urethra excision ; Effmann classification ; Urethral duplication ; Urethroplasty ; Y duplication
Abstract
Purpose: To present our experience in urethral duplication focusing on detailed surgical management. Methods: We retrospectively reviewed the records of 12 male patients treated for urethral duplication between 2005 and 2017. Evaluations included ultrasound, retrograde urethrography, cystoscopy, and voiding cystourethrography. Results: The age at presentation ranged from birth to 11 years. All 12 cases were classified using the Effmann classification. Case 1-4 patients with type I underwent excision of the dorsal accessory urethra by stripping technique. In case 5 patient(type IA) with two adjacent apical urethras, the septum was opened to form a single channel. Case 6 patient with type IB underwent visual internal urethrotomy near bulbous urethra to combine urethra into one channel. Five patients classified as type II (one with a type IIA1, and four with type IIA2 urethras). Urethral duplication was incidentally found during epispadias repair in case 7 patient with type IIA1, which was corrected by ventral plication, and excision of the dorsal epispadial urethra with stripping technique just below pubic bone. Case 8 patient with type IIA2 also required dorsal urethral excision with stripping technique. The two Y-type patients (case 10, 11) underwent urethrourethrostomy with a single-stage buccal mucosa tube graft, followed by repetitive surgeries owing to urethral stricture. One type III patient presented with penile inflammation and suprapubic pain, and underwent excision of both the dorsal urethra and nonfunctional anterior bladder. Conclusions: Urethral duplication requires individualized surgical approaches based on the anatomical and functional characteristics. Because prognosis is variable depending on type and accompanied anomalies, these should be taken into account when planning a comprehensive workup and surgical management. Level of evidence: Level IV.
Full Text
https://www.sciencedirect.com/science/article/pii/S0022346819308978
DOI
10.1016/j.jpedsurg.2019.12.012
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sung Ku(강숭구) ORCID logo https://orcid.org/0000-0002-3143-507X
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180500
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