Duplication of the urethra in an adult male presenting with scrotal fistula: a rare case report

Abstract

Urethral duplication is a rare congenital abnormality with varied clinical manifestations; to this day, <300 cases were reported in the literature. It is affecting mainly males and is nearly always diagnosed in childhood or adolescence. It may be complete or incomplete, and the most widely accepted classification of the different types of urethral duplication was developed by Effman et al. Herein, we present a rare case of urethral duplication revealed by scrotal fistula in an adult man. A duplication is an unusual form of Y-type duplication: it is an incomplete urethral duplication urethra opening on the scrotum without communication with the urethra or bladder.

Congenital Effman type 2A II urethral duplication with hypoplastic ventral glandular urethra

“…Embryogenic development of UD is not well understood and various hypotheses exist, but none can explain all types of presentations. 1,9 Congenital UD can have different clinical manifestations, such as deformed penis, double urinary streams, urinary tract infection, urethral discharge, and out-flow obstruction or can be asymptomatic. In most previously reported cases, the accessory urethra ends most commonly with an epispadic opening but can also end in mid glans and continence of it is maintained due to intact sphincteric function.…”

“…Effmann et al described classification of urethral duplication into three types and are currently mostly reported classification in the literature. 1,5 Numerous hypotheses have been put forward; however, there is ambiguity in regard to its embryology as the same explanation does not apply to all subdivisions of urethral duplication.…”

Type IIB urethral duplication in adult: A case report

“…Urethral duplication is a rare congenital abnormality. Embryogenesis is not well understood and various hypotheses exist, but no one can explain all type of presentation, the common pathological process is supposed to result from an abnormal relationship between the lateral folds of the genital tubercle and the central end of the cloacal membrane and the duplication commonly occurs in the sagittal plane with 1 urethra located centrally and the other dorsally [5] . The frequency of this anomaly is mostly in males, and few cases in females [4] .…”

“…In this case, adult male patient was coming with dysuria. The urethral duplication has multiple presentation, with a lack of specificity going from the asymptomatic, dysuria, deformed penis, twin streams, urinary tract infection, symptoms of bladder outlet obstruction to various other signs like a renal failure as one of the worst [5] . In this case, chief complain of patient is dysuria after catheter removal.…”