AbouZeid Amr AbdelHamid, Safoury Hesham Soilman, Mohammad Shaimaa AbdelSattar, El-Naggar Osama, Zaki Ahmed Medhat, Hassan Tarek Ahmed, Hay Sameh Abdel
Ain-Shams University, Lotefy El-Sayed, Abbassia, Cairo, Egypt.
Ain-Shams University, Cairo, Egypt.
Ther Adv Urol. 2015 Apr;7(2):76-84. doi: 10.1177/1756287214561760.
The aim of this article was to describe our experience with 14 patients with double urethra.
We retrospectively examined the patients' records including their clinical presentations, investigations, operative findings, and outcome. In addition to Effmann's classification, we used a newly proposed classification that depends on the orientation of the double urethral channels.
During the last 15 years, 18 patients were diagnosed to have double urethra at our pediatric surgical unit. We excluded four patients with 'Y-type' urethral duplication. The remaining 14 patients were divided into either sagittal or collateral duplication. Their age at presentation ranged from the neonatal period to 9 years. The sagittal urethral duplication included 12 male patients. All patients had two urethral channels, one above the other. The dorsal urethral channel was always characterized by poor function and ectopic course. The ventral channel was always the more functioning urethra, with a normal course from the urinary bladder to end either at an orthotopic meatus (subgroup A), or more proximally in a hypospadiac location (subgroup B). The collateral urethral duplication included two patients. Both patients were associated with duplication of the urinary bladder and the external genitalia as a part of caudal duplication syndrome. In this group, both urethrae had comparable function, lying side by side, and each draining a separate urinary bladder.
The double urethra is a diverse spectrum comprising different pathologies. Our proposed classification system of duplicated urethras is clinically relevant as it guides surgical management and allows prognostication of outcome.
本文旨在描述我们对14例双尿道患者的治疗经验。
我们回顾性研究了患者的病历，包括临床表现、检查、手术发现及结果。除了埃夫曼分类法外，我们还采用了一种新提出的根据双尿道通道方向进行的分类法。
在过去15年中，我们小儿外科诊断出18例双尿道患者。我们排除了4例“Y型”尿道重复畸形患者。其余14例患者分为矢状位或并列位重复畸形。他们就诊时的年龄从新生儿期到9岁不等。矢状位尿道重复畸形包括12例男性患者。所有患者均有两条尿道通道，一条在另一条上方。背侧尿道通道功能总是较差且走行异位。腹侧通道功能总是较好，从膀胱正常走行至正位尿道口（A亚组）或更靠近近端的尿道下裂位置（B亚组）结束。并列位尿道重复畸形包括2例患者。这2例患者均伴有膀胱和外生殖器重复畸形，是尾侧重复畸形综合征的一部分。在该组中，两条尿道功能相当，并列存在，且每条尿道引流一个单独的膀胱。
双尿道是一种包含不同病理情况的多样疾病谱。我们提出的尿道重复畸形分类系统在临床上具有相关性，因为它可指导手术治疗并有助于预测预后。
