Urethral duplication: from the careful examination to surgical repair

Background. Urethral duplication is a rare lower urinary tract anomaly; less than 200 cases have been described in the literature, defined by two urethra, one orthotopic and the second ectopic. This study aimed to highlight the different spectrums or varieties of this rare anomaly to show the goal of careful examination and exploration to define the central urethra and the accessory urethra. Materiel and methods. retrospective study review of 10 cases of urethral duplication was operated between January 2018 and December 2022, age at the first consultation ranged from 15 months to 6 years. Urethral duplication is classified using Effmann classification. Results. Independent urethra was observed in 2 cases, urethral duplication type ⅡA2 in two instances, urethral duplication type ⅡA2, duplication in 1 case, urethral duplication with accessory epispadias urethra in 4 cases and blinded end duplication in two instances (typeⅠ). The most common associated urinary tract disorder was VUR, which was present in 4 patients, and bilateral in 2 patients. Discussion. Urethral duplication is a rare anomaly, with poor sample cases described in the literature and not always identified in childhood. Classifications described malformations, but the most used classification was established by Effmann. The Evaluation included Ultrasonography, retrograde urethrography, and MRI. Surgical repair was indicated in all cases in cosmetic or symptomatic form. Conclusion. A rare condition that should be considered in cases of double stream by careful examination; associated malformations may be found and may be underdiagnosed. Surgical repair was defined according to anatomical findings, including excision of the accessory urethra and mucosal excision in Y duplication rather than excision.