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Urethral duplication in children: Our experience of eight cases
Authors:SB Mane  Abu Obaidah  Nitin P Dhende  Jamir Arlikar  Himanshu Acharya  Ashokanand Thakur  Suyodhan Reddy
Institution:1. Our Lady''s Children''s Hospital, Crumlin, Cooley Road, Dublin, 12, Ireland;2. Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin, 2, Ireland;1. Division of Pediatric Urology, Texas Children''s Hospital, Houston, TX, USA;2. Institute for Pediatric Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA;3. Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA;4. Anne Arundel Urology, Annapolis, MD, USA;5. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Abstract:ObjectiveDuplication of urethra has varied presentations and multiple techniques have been described for its correction. We present our experience in the management of this anomaly.Material and methodWe retrospectively reviewed the records of eight patients treated for urethral duplication in 1998–2008. We managed four cases of Y-duplication, three of whom underwent buccal mucosal tube urethroplasty and one urethrourethrostomy. Two patients presented with double stream (type II A2); in one urethrourethrostomy was done and the other child underwent vesicostomy as initial treatment. Two cases were of type II B duplication (two urethra opening as single meatus); one required only dilatation of urethra and the other excision of accessory tract.ResultMean age at presentation was 56.9 months. Associated anomaly was present in only two patients. Single-stage procedure was done in four patients and multi-staged procedure in three patients. Overall mean number of procedures required was 2.8; more were required in the case of Y-duplication compared to the other types. On follow-up all patients were passing urine in single stream.ConclusionThorough work up to detect any associated anomaly and type of duplication is required for the management of urethral duplication. Single-stage repair with buccal mucosa as tube urethroplasty in cases of Y-duplication is feasible with good outcome.
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