Pediatric Urology Research Center Pediatric Center of Excellence, No. 32, 2nd Floor, 7th Street, Saadat-Abad, Ave., 1998714616 Tehran, Iran.
Int Urol Nephrol. 2012 Feb;44(1):41-4. doi: 10.1007/s11255-011-9981-2. Epub 2011 May 6.
The concomitant presence of urethral triplication and caudal duplication is extremely rare with no previous reported cases. We report a case of urethral triplication associated with bladder, sigmoid, and rectum duplication. The patient was initially referred with a history of fecaluria and recurrent urinary tract infection. Physical examination revealed 2 meatal opening on the glans penis. Further investigation revealed three distinct urinary streams, two terminating on the glans penis, and one in the rectum in voiding cystourethrography and retrograde urethrography. Computed tomography demonstrated the bladder divided into two compartments by a complete sagittal septum. The patient was managed by the excision of the rectal ending urethra and removal of the bladder sagittal septum during which, two sigmoidal and rectal segments (the right one filled with fecal) were revealed. The right sigmoid and rectum was resected. The two ventral urethras were kept intact. The postoperative course was uneventful. At his 4 month readmission for colostomy closure, the patient reported good urethral voiding with no complication and recurrence of urinary tract infection and the colostomy was closed with no major complication.
尿道三重化伴尾部重复极为罕见，此前尚无报道。我们报告一例伴膀胱、乙状结肠和直肠重复的尿道三重化。该患者最初因粪尿和复发性尿路感染就诊。体格检查发现阴茎球部有 2 个尿道口。进一步检查显示，在排尿性膀胱尿道造影和逆行尿道造影时，有 3 股不同的尿流，其中 2 股终止于阴茎球部，1 股在直肠。CT 显示膀胱被完整的矢状隔分为两部分。患者接受了直肠末段尿道切除术和膀胱矢状隔切除术，术中发现两个乙状结肠和直肠段（右侧充满粪便）。右侧乙状结肠和直肠被切除。两个腹侧尿道保持完整。术后过程顺利。在他 4 个月后的结肠造口关闭时，患者报告尿道排尿良好，无并发症，尿路感染无复发，结肠造口关闭无重大并发症。
