Duplication of urethra is uncommon birth defect in which the urethra is duplicated. The degree of the duplication is changeable with a whole duplication of the urethra but it is very rare condition. Complete duplication includes 2 external urinary outlets which resulting in 2 urinary streams.
SYMPTOMS:
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Duplicated urinary stream
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Obstructed bladder outflow tract
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Frequent urinary tract infections
Mostly duplications may occur with one urethra one is top on the other. Rarely, duplex urethras may occurs side by side. This is generally in the situation where a child has 2 complete penises, but they may also occurs if the penis are fused but widened. Most of these children those are having 2 bladders, in addition to that two normal urethras, and only need surgery if it is essential for cosmetic reasons. The general situation of one of the urethra is on top of another occurs in ventral and dorsal varieties.
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In dorsal duplication of the urethra, a common urethra will follows a usual channel and ends in a usual hole at the penis tip. Another opening is seen on the upper surface of the penis, anyplace between the tip and the base. This additional urethra may end in a blind pouch before reaching the bladder. If it does extend the entire length and insert into the bladder, the child will usually pass urine out of this urethra, since there is no sphincter apparatus to restrain urine flow. Surgery is sometimes needed for incontinence or for infections which are occurring repeatedly. Since the usually located urethra has a normal bladder neck and sphincter mechanism, surgical treatment consists of simply excising the extra urethra.
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The ventral variety is the most variable and less well understood. In some cases, 2 complete urethras come off the bladder; in some other cases, the urethra divides somewhere along the path. The opening from the 2nd urethra is usually located on the underneath of the penis, but it can appear further down, even as far away as the anterior rim of the anus. The closer the opening is to the anus, the more possible that this unusually placed urethra is the normal one, with the working sphincter mechanism. The normally located penile urethra is often poor in function, narrow and inelastic. As an adult, ejaculation would also occur out of the anal urethra, not necessarily diminishing sexual pleasure, but certainly affecting fertility.
DIAGNOSIS:
In males, the partial or complete duplication of the urethra can be diagnosed by urethography. Possible duplication of the female urethra is studied better in MRI scan.
