Altuntas Turker, Ozkan Onur Can, Yucel Selcuk, Cam Kamil, Tarcan Tufan, Sekerci Cagri Akin
Department of Urology, Marmara University, School of Medicine, Istanbul, TUR.
Department of Urology, Pediatric Urology Division, Marmara University, School of Medicine, Istanbul, TUR.
Cureus. 2025 Aug 27;17(8):e91120. doi: 10.7759/cureus.91120. eCollection 2025 Aug.
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.
我们旨在呈现一例在围手术期发现的尿道重复病例，并讨论该异常情况的处理。计划对一名患有尿道下裂的一岁男性患者进行远端修复。术中首次发现了一种先前未报道的1B型尿道重复变异（埃夫曼分类）。采用包皮覆盖皮瓣进行尿道成形术，将盲端的腹侧尿道与功能性尿道吻合，随后完成尿道下裂修复。尿道重复的处理应根据重复类型和患者症状进行个体化。诊断评估可能包括膀胱尿道镜检查、排尿性膀胱尿道造影、逆行尿道造影和超声检查，以检测相关异常。尽管切除背侧副尿道是最常进行的手术，但对于最佳手术方法尚无共识。无症状的尿道重复可能在尿道下裂手术中偶然被发现。在我们的病例中，1B型变异通过尿道成形术进行处理。考虑到该病例的手术规划和术中发现，即使是远端尿道下裂修复也需要全面评估，并且应在有能力处理其他先天性异常的经验丰富的中心进行。
