Arda Irfan S, Hiçsönmez Akgün
Department of Pediatric Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
J Pediatr Surg. 2002 Aug;37(8):1213-5. doi: 10.1053/jpsu.2002.34479.
Urethral duplications are rare anomalies that manifest in various anatomic forms. These variations are classified broadly as epispadic, hypospadic, and Y-type duplications. In the Y-type, the accessory ventral channel opens into either the perineum or the anal canal. Typically, the dorsal urethra is hypoplastic, and the external meatus is stenotic, so urine is voided through the dominant ventral channel. In the other unusual form, the dorsal urethra is normal and perineal or rectal opening of accessory ventral urethra is an accidental finding. When treating patients with typical Y-type duplications, the accessory ventral urethra is mobilized and then is carried to the glans with one- or 2-stage urethroplasty. In the unusual form, excision of the anterior urethra is the definitive surgical treatment. This report describes a case of unusual Y-type urethral duplication in which the accessory ventral channel had a stenotic perianal opening. The patient developed recurrent attacks of perianal abscess associated with urinary tract infections. To the authors' knowledge, this is the first reported case of Y-type duplication with an hypoplastic accessory ventral channel that was presented with recurrent perianal abscess attacks.
尿道重复畸形是一种罕见的异常情况，有多种解剖形式。这些变异大致可分为尿道上裂型、尿道下裂型和Y型重复畸形。在Y型中，副腹侧通道开口于会阴或肛管。通常，背侧尿道发育不全，尿道口狭窄，因此尿液通过主要的腹侧通道排出。在另一种不寻常的形式中，背侧尿道正常，副腹侧尿道的会阴或直肠开口是偶然发现的。治疗典型Y型重复畸形患者时，游离副腹侧尿道，然后通过一期或二期尿道成形术将其移至龟头。在不寻常的形式中，切除前尿道是确定性的手术治疗方法。本报告描述了一例不寻常的Y型尿道重复畸形病例，其中副腹侧通道有狭窄的肛周开口。该患者出现与尿路感染相关的复发性肛周脓肿发作。据作者所知，这是首例报告的伴有发育不全的副腹侧通道且表现为复发性肛周脓肿发作的Y型重复畸形病例。
