Presentation
CASE REPORT A six-year-old child presented with ambiguous genitalia and urinary incontinence. [ncbi.nlm.nih.gov]
[…] and Diagnosis 256 Double Urethra and Accessory Urethra 257 Incomplete Dorsal Accessory Urethrablind 258 Incomplete Dorsal Accessory UrethraCommunicating with the Urethra 259 Etiology and Pathology 261 Clinical Presentation 268 Diagnosis 270 Treatment [books.google.com]
According to this classification; the present case was type II A-2 (complete urethral duplication with the second urethra arising from first one and coursing independently into separate meatus). Clinical presentation varies from type to type. [f1000research.com]
Case Report First Online: 14 December 2010 Abstract An unusual case of crossed renal ectopia (sigmoid kidney) in an adult, compounded with double urethra, is being presented for its rarity and mode of presentation. [link.springer.com]
Due to the rarity of this association, one may not identify both the problems which may present as a diagnostic challenge. [bjuinternational.com]
Entire Body System
- Swelling
He presented with swelling of the penis, which increased in size with urination. General examination revealed an otherwise healthy child. [f1000research.com]
In embryos of 60 mm. head-foot length this becomes raised up in toto and forms the unpaired scrotal swelling, into which the two genital swellings, which we now must term the scrotal swellings, extend from above. [embryology.med.unsw.edu.au]
The boy had a history of a swelling at the penoscrotal region during micturition. [ijri.org]
The baby failed to void after fulguration of posterior urethral valves and a fluctuant swelling was seen at the penoscrotal junction when he attempted to void. A repeat VCUG was done that showed a large urethral diverticulum. [bjuinternational.com]
- Sepsis
Concurrently, ureteral stenting may be associated with sepsis, irritative bladder symptoms and a high failure rate, which ultimately leads to a nephrostomy tube [ 2 ]. [ncbi.nlm.nih.gov]
- Severe Pain
Children with lacuna magna can report intermittent postvoid spotting, hematuria, dysuria, or severe pain in the vicinity of the glans during voiding. [emedicine.medscape.com]
Urogenital
- Renal Insufficiency
Patients may also present as urinary tract obstruction or chronic renal insufficiency. Diagnosis is made during a physical examination, supplemented by voiding cystourethrography, retrograde urethrogram, and urethrocystoscopy. [ncbi.nlm.nih.gov]
Urologic sequelae of urethral valves include urinary hesitancy, decreased urinary stream, urinary tract infection, overflow incontinence, myogenic bladder malfunction, vesicoureteral reflux, upper urinary tract damage, and renal insufficiency. [merckmanuals.com]
Patients may also present as urinary tract obstruction or chronic renal insufficiency. [read.nxtbook.com]
- Kidney Failure
Upper tract infections, by contrast, can be serious for both adults and children, causing high fevers, back pain, severe generalized discomfort, and even leading to kidney failure or septicemia (infection spreading throughout the body by way of the blood [healthofchildren.com]
Workup
Colonoscopy
- Polyps
Symptoms of congenital urethral polyps in children include intermittent bladder obstruction, hesitancy, hematuria, dysuria, splayed urinary stream, and UTI. [emedicine.medscape.com]
An oblique VCUG image shows a dilated posterior urethra (arrow) and a trabeculated urinary bladder Click here to view Posterior urethral polyp Posterior urethral polyp, a rare cause of intermittent urethral obstruction, [16] is an elongated pedunculated [ijri.org]
This anomaly may be accompanied by various pathological conditions, including hypospadias, epispadias, anterior urethral valve, lacuna manga, prostatic urethral polyps, megalo-urethra, syringocele (dilated Cowper gland), and congenital urethral fistula [jpma.org.pk]
Treatment
Babies with birth defects often need special care and treatments. The treatments may include surgery, medicines, assistive devices, and therapies. [icdlist.com]
271 Prognosis 278 References 281 Anomalies of the Male Genitalia By RoBERT J PRENTIss With 15 Figures 287 Method of Examination 288 Surgical Treatment 289 Surgical Principles 292 [books.google.com]
Treatment for vesicoureteral reflux VUR may go away with no treatment in some children, which is more likely in younger children and in less severe cases. Antibiotics are generally the first treatment to stop the UTI. [denverurology.com]
Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. [rarediseases.info.nih.gov]
When deciding the most appropriate form of treatment, it's important to take into account the stricture etiology, location, and severity, prior treatments, comorbidities, and patient preference. [medicinenet.com]
Prognosis
Diagnosis 256 Double Urethra and Accessory Urethra 257 Incomplete Dorsal Accessory Urethrablind 258 Incomplete Dorsal Accessory UrethraCommunicating with the Urethra 259 Etiology and Pathology 261 Clinical Presentation 268 Diagnosis 270 Treatment 271 Prognosis [books.google.com]
In partial epispadias, prognosis for continence with treatment is good. [merckmanuals.com]
Prognosis As long as damage to the kidneys from infection or back pressure has not become significant, the surgical repair of troublesome ureteral defects produces excellent long-term results in the great majority of cases. [healthofchildren.com]
: Bladder exstrophy associated with complete urethral duplication: a rare malformation with excellent prognosis. J Urol. 2001; 165 (6 Pt 2): 2434–37. PubMed Abstract | Publisher Full Text 2. Das S, Brosman SA: Duplication of the male urethra. [f1000research.com]
Etiology
[…] and Pathology 254 Clinical Presentation and Diagnosis 256 Double Urethra and Accessory Urethra 257 Incomplete Dorsal Accessory Urethrablind 258 Incomplete Dorsal Accessory UrethraCommunicating with the Urethra 259 Etiology and Pathology 261 Clinical [books.google.com]
Embryology, etiology, and clinical appearance of this rare anomaly are discussed. © 2007 S. Karger AG, Basel References Boissonnat P: Two cases of complete double functional urethra with a single bladder. Br J Urol 1961;33:453–462. [karger.com]
The precise etiology of both the conditions remains elusive and various postulates exist. Due to the rarity of this association, one may not identify both the problems which may present as a diagnostic challenge. [bjuinternational.com]
It is divided into complete and incomplete forms and although there are several theories to explain its embryological origin, the exact mechanism of its etiology is not known and no single theory explains all the various types of urethral duplications [jpss.eu]
When deciding the most appropriate form of treatment, it's important to take into account the stricture etiology, location, and severity, prior treatments, comorbidities, and patient preference. [medicinenet.com]
Epidemiology
We provide invaluable learning opportunities for attending medical students and research opportunities in biomedical, clinical and epidemiological research across all disciplines. [sydney.edu.au]
"Epidemiology". Medscape Reference. Retrieved 22 January 2013. ^ Mieusset, Roger; Soulié, Michel (2005). "Hypospadias: Psychosocial, Sexual, and Reproductive Consequences in Adult Life". [en.wikipedia.org]
Pathophysiology
Pathophysiology [ edit ] Ureteral development begins in the human fetus around the 4th week of embryonic development. [en.wikipedia.org]
Prevention
Prevention The cause of congenital ureter anomalies is not known. There is no prevention. Resources BOOKS Colberg, John W. "Urologic Abnormalities of the Genitourinary Tract." Chapter 21, section 16, in Rudolph's Pediatrics, 21st ed. [healthofchildren.com]
The valve that normally prevents urine reflux is called the vesicoureteral valve. The danger for children with VUR is that a resulting urinary tract infection (UTI) weakens the urinary tract’s ability to prevent bacteria from entering the kidney. [denverurology.com]
Centers for Disease Control and Prevention Intersex (Medical Encyclopedia) [ Read More ] Urethral Disorders The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis. [icdlist.com]
Antibiotics A long course of antibiotics may be advised to prevent urine infections until a stricture has been widened. [patient.info]
Surgery (usually via endoscopy) is done at time of diagnosis to prevent progressive renal deterioration. [merckmanuals.com]