Urethral duplication in children: our experience of eight cases.

OBJECTIVE: Duplication of urethra has varied presentations and multiple techniques have been described for its correction. We present our experience in the management of this anomaly.

MATERIAL AND METHOD: We retrospectively reviewed the records of eight patients treated for urethral duplication in 1998-2008. We managed four cases of Y-duplication, three of whom underwent buccal mucosal tube urethroplasty and one urethrourethrostomy. Two patients presented with double stream (type II A2); in one urethrourethrostomy was done and the other child underwent vesicostomy as initial treatment. Two cases were of type II B duplication (two urethra opening as single meatus); one required only dilatation of urethra and the other excision of accessory tract.

RESULT: Mean age at presentation was 56.9 months. Associated anomaly was present in only two patients. Single-stage procedure was done in four patients and multi-staged procedure in three patients. Overall mean number of procedures required was 2.8; more were required in the case of Y-duplication compared to the other types. On follow-up all patients were passing urine in single stream.

CONCLUSION: Thorough work up to detect any associated anomaly and type of duplication is required for the management of urethral duplication. Single-stage repair with buccal mucosa as tube urethroplasty in cases of Y-duplication is feasible with good outcome.