Variant of Type 1B Duplicated Urethra in a Distal Hypospadiatic Boy: A Case Report

We aimed to present a case of urethral duplication detected perioperatively and to discuss the management of this anomaly. Distal repair was planned for a one-year-old male patient presenting with hypospadias. Intraoperatively, a previously unreported variant of type 1B urethral duplication (Effmann classification) was identified for the first time. Augmentation urethroplasty using a preputial onlay flap was performed to anastomose the blind-ending ventral urethra with the functional urethra, followed by completion of hypospadias repair. Management of urethral duplication should be individualized based on the type of duplication and the patient's symptoms. Diagnostic evaluation may include cystourethroscopy, voiding cystourethrography, retrograde urethrography, and ultrasonography to detect associated anomalies. Although dorsal accessory urethral excision is the most commonly performed procedure, there is no consensus on the optimal surgical approach. Asymptomatic urethral duplication may be detected incidentally during hypospadias surgery. In our case, a type 1B variant was managed with augmentation urethroplasty. Considering the planning and intraoperative findings of this case, even distal hypospadias repairs require comprehensive evaluation and should be performed in experienced centers capable of managing additional congenital anomalies.