Urethral duplication

Last revised by Henry Knipe on 9 Nov 2023

Urethral duplication is a rare condition in which either a part of the entire urethra is duplicated. It usually occurs in the sagittal plane and the more dorsal copy is usually the duplication.

Urethral duplications may occur due to a variety of developmental anomalies. In females, it is thought to arise from delayed fusion of the Mullerian ducts and urogenital sinus 2

The Effman classification is the most used system to distinguish the several types of urethral duplication in males.

Retrograde urethrography and voiding cystourethrography are considered the main diagnostic procedures and can visualize the size, shape and position of the two channels ref.

The diagnosis can also be made by ultrasound and/or MRI. In females, MRI may be the better modality with two high signal-intensity central spots may be apparent on an axial view of the pelvis in the region of the urethra ref. MRI additionally can characterize the periurethral tissues and any associated genitourinary abnormalities. 

A small retrospective study has found the use of both buccal and urinary bladder mucosa for urethral repair have good results and that Y-type urethral duplication is most difficult to repair surgically 5.

In a male, hypospadias can be considered (glanular dimple not patent).

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