Case Report 1602752 EurUrol 1994;26:182-183 Prostatic Urethral Duplication: An Unusual Form of Vertical Symmetric Duplication Mehmet Kihnça Ahmet Arslanb Mehmet Arslan* Kadir Yilmaza Atilia Semerciöz3 Departments of a Urology and b Biology and Genetics, Faculty of Medicine, Selçuk University, Konya, Turkey Key Words Urethral duplication Abstract Urethral duplication is a rare anomaly that manifests itself in various ways. We present a case with a prostatic urethral duplication without incontinence. To our knowledge this is the first case to be reported and has been discussed within Effmann ’ s classification. Introduction nous. Endoscopic examination did not show any other pathologic features. Because of urinary tract obstruction, transurethral resection was made. A No. 4 ureteral catheter was inserted into the duplicate on the right. Excision was made starting from the duplicate on the left. Non- membranous septal tissue was removed by transurethral resection, and the urinary stasis was relieved. The indwelling 12-french urethral catheter was removed 4 days after the operation. On the 7th day after the operation the patient was discharged from the hospital. One month later, postoperative control was made, and the patient was uneventfully free of obstruction. At another follow-up, 5 months after the operation, a voiding cystourethrogram did not show any evidence of vesicoureteral reflux. Urethral duplication is a rather rarely seen anomaly [1-5]. Blind- ending incomplete urethral duplication is the most common among the urethral duplication cases, is usually asymptomatic and requires no treatment [1,3]. Clinically, complete patent duplication can occur either as an isolated deviation or associated with other caudal anom - alies [2, 3,6, 7], However, vertical urethral duplication in the prostat - ic region was not reported before, and this is the only case having such a reduplication of the urethra. Case Report A male boy, 8 years old, was referred to our clinic w ith a com- plaint of urinary outflow obstruction. On the physical examination, he had a normal penis and scrotum. He had no obvious physical abnormalities. Urinary analysis did not show any infectious condi - tion. Excretory urography followed by voiding cystourethrography showed m ild ectasis of the right kidney pelvis and ureter, obstruction caused by vesical changes and prostatic urethral duplication (fig. 1, 2). A voiding cystourethrogram obtained later on revealed a grade 1 vesicoureteral reflux (fig. 2). Endoscopic examination re- vealed a vertical septum-like formation in the prostatic urethra and light hypertrophy of the verumontanum; its thickness was about 2 mm. The vertical septum originated from the bladder neck, cir - cumvented the verumontanum righthandedly and extended to the membranous urethra. However, the septal tissue was nonmembra- Discussion Urethral duplication is a generally asymptomatic rare anomaly and usually recognized as secondary to primary complaints. Com - plaints related w ith urethral duplication are associated with double urinary stream, incontinence, dysuria, recurrent urinary infections, outflow obstruction or chordee [1, 2, 6, 8], and the magnitude of the symptoms is usually related to the type of duplication [2]. Purcell [9] reported an unusual accessory urethra which was separated from the posterior urethra by a mucosal wall. Based on his cystoscopic obser- vation it was presumed that when urine struck on the wall of the accessory urethra it became enlarged and constricted the posterior urethra causing urinary retention. The case reported here is symmet - ric complete prostatic urethral duplication with a well-developed ver- Doç. Dr. Mehmet Kilmç Selçuk Üniversitesi Tip Fakültesi Üroloji ABD 42080-Konya (Turkey) © 1994 S. Karger AG, Basel 0302-2838/94/0262-0182 $8 .00/0 Downloaded by: University of Exeter 144.173.6.94 - 6/9/2020 12:45:17 PM