Duplication urétrale épispade: Diagnostic et prise en charge. à propos d’un cas

Urethral Duplication with a Cystic Phallic Urethra Associated with a Uterus Didelphys, Partial Agenesis of the Tibia, and an Equinovarus Foot

“…One urethra is usually normal and the other is an accessory urethra. It may be either frontal or sagittal, and depending on whether the external orifice of the accessory urethra opens above or below the external orifice of the main urethra (the one with a markedly stronger urine flow), this distinguishes epispadic and hypospadic urethral duplications [1]. The male urethral duplication is divided into three types according to Effman's classification [3].…”

“…Various theories have been proposed for development of urethral duplication, but no single theory explains all the various types of anomalies [1]. The most widely accepted theory for the cause of complete urethral duplication is that of Patten and Barry.…”

“…According to them, an abnormal relationship exists between the lateral anlagen of the genital tubercle and the ventral end of the cloacal membrane. [1, 4, 6]. The opening of the urethra in the vagina corresponds to a defect of the urethrovaginal septum which may be total, allowing a direct communication of the bladder with the vagina, or more frequently partial [2].…”

“…In our case, voiding radiographs revealing the two ureters simultaneously were not obtained, but the two-stage opacification of each urethral orifice made it possible to visualize the urethral pathways and their orifices. The plain films also revealed a pubic symphysis disjunction, which is often associated and must be systematically verified [1]. …”

“…Urethral duplications are among the rarest congenital malformations of the urinary tract, with about 500 cases described in the literature in 2008 [1]. They are defined by the existence of 2 urethras, with several reported anatomical variants, associated or not with genital malformations.…”