Effman Classification of urethral duplication

Last revised by Dr Jeremy Jones on 30 Apr 2022

The Effman classification is a widely adopted system to classify the several distinct types of urethral duplication. It's considered to be the most complete classification from a clinical and functional point of view, but it's only based on male forms and does not distinguish sagittal from coronal duplications. 

Incomplete urethral duplication

  • type IA: Opening on the dorsal or ventral surface of the penis without communication with the urethra or bladder
  • type IB: Communicating proximaly with the urethra but does not open on the penis surface

Complete patent urethral duplication

  • type IIA1: Two totally independent urethras arising separately from the bladder
  • type IIA2: accessory urethra arising from the main one and courses independently toward its own meatus
  • type IIA2-Y: A particular form of IIA2 type with a ventral urethra opening in the perinium, referred to as congenital posterior urethro-perineal fistula (CUPF)
  • type IIB: Two urethras arising separately from the bladder and unite distally to open in one meatus

Urethral duplication associated with caudal duplication

This classification was initially set by Effman, Lebowman and Colodny in 1976, and later modified by Bello in 2014, including CUPF as a type IIA2-Y since it has a different treatment compared to other IIA2 type defects.

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