| Abstrakt: |
A total of 16 cases of urethral duplication in boys have been treated over a period of 20 years. Applying the classification described by Innes Williams cases could be divided into: epispadial urethral duplications, hypospadial duplications, spindle urethras, bifid urethras with an accessory preanal branch, and finally collateral duplications. The 16 cases reported were an epispadial double urethra (3 duplicated and 2 bifid) in 5 cases, a hypospadial duplication (4 bifid and 6 blind urethras) in 10 cases, and a bifid urethra with an accessory preanal branch in one case. Not one of the other forms was observed. Treatment of epispadial double urethras consisted mainly of almost total ablation of the supernumerary urethra with freeing of the corpus cavernosum when dorsal incurving developed during erection. The blind forms associated with the hypospadias in hypospadial duplications have no incidence on treatment. In the incomplete forms, treatment is based on four principles: the impossibility of using the superior urethra which extends to the end of the penis, as it is to narrow, implying its opening up to the region facing the hypospadial meatus and the transformation of this incomplete urethral duplication into a single orifice hypospadias; endoscopic resection of the mucosal folds producing a valve effect at the junction between the 2 urethras; the need to straighten an angled penis; and finally the performance of a urethroplasty using the same rules as for surgery of hypospadias. Treatment of bifid urethras with accessory preanal branches depends on the condition of the principal urethra. When this is normal it is sufficient to excise the accessory branch.(ABSTRACT TRUNCATED AT 250 WORDS) |
