Presentation
The patient presented to the clinic for circumcision due to penioscrotal webbing. During circumcision, after making a dorsal slit, he was noted to have possible urethral duplication.
Patient Data
The VCUG image shows a thin linear contrast track extending parallelly and separately from the region of the posterior urethra anteriorly up to the meatus, following the course of the normal urethra, which represents the double urethra.
The second image shows focal dilation and contrast filling posterior to the proximal urethra, representing the utricular cyst.
Cystic lesion posterior to the urinary bladder with internal echoes or debris represents a utricular cyst.
Case Discussion
There is an embryological association between the double urethras and utricular cysts. Both conditions arise from anomalies linked to the development of the urogenital sinus and the paramesonephric duct.
Embryological correlation:
utricular cysts are believed to develop from the remnants of the utricle. An enlarged or persistent utricle can progress into a utricular cyst, especially if there is an obstruction of the utricular opening. A persistent utricle could be due to incomplete fusion of the urogenital folds or other developmental anomalies
double urethra or urethral duplication can occur if there is an abnormal division of the urogenital sinus or an abnormal development of the urethral plate. This results in the formation of two parallel ureters instead of a single, fused urethra
Both conditions, the utricular cyst and double urethra, can be noticed in the context of other urogenital anomalies. For instance, an enlarged utricle or utricular cyst may be associated with posterior urethral valves, hypospadias, or other congenital malformations of the main urogenital tract.
In summary, the relationship between double urethra and utricular cysts lies in their shared embryological origin from the urogenital sinus. Abnormalities in the development of this structure and its associated ducts can lead to various urogenital anomalies.
Contributors: Nadim Abu-Hashem, MD., Anand Majmudar, MD., Ravikumar Hanumaiah, MD.
Unable to process the form. Check for errors and try again.