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Double Urethra

Duplication of Urethra


Presentation

  • Case Report A 15-year-old boy presented with a complaint of a double stream of urine since birth. He had no difficulty with micturition ( Figure 1A ) There was no history of recurrent urinary tract infection.[ncbi.nlm.nih.gov]
  • On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are[icd10data.com]
  • Case report A 16 month old male child from India with duplication of the urethra and a diverticulum arising from ventral urethra was presented at our clinic in 2013. He presented with swelling of the penis, which increased in size with urination.[f1000research.com]
  • […] 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]
  • 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]
Asymptomatic
  • The patient was not offered surgical intervention as he was asymptomatic and had no problems except for a double stream of urine.[ncbi.nlm.nih.gov]
  • People with complete urethral duplication can be asymptomatic or can present with a double stream of urine, incontinence, recurrent infections, or outflow obstructions.[rarediseases.info.nih.gov]
  • Many patients are asymptomatic and do not require any surgery. Indications for surgery are bothersome symptoms and cosmetic or functional deformity. Surgical reconstruction varies from case to case.[f1000research.com]
  • This type is usually asymptomatic and many cases pass unnoticed till adulthood especially if the child is not going to be circumcised.[jpss.eu]
Physician
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers.[rarediseases.info.nih.gov]
  • Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.[drgreene.com]
  • A physician performs the procedure in the office under local anesthesia or in the operating room under general anesthesia.[medicinenet.com]
  • If your child has a history of frequent urinary tract infections, your child's physician may order the following diagnostic procedures: Ultrasound of the entire urinary tract.[stanfordchildrens.org]
Soft Tissue Swelling
  • Local examination revealed an approximately 4 2cm sized soft tissue swelling on the ventral aspect of the distal part of penis, cystic in nature ( Figure 1A ).[f1000research.com]
Abdominal Distension
  • This was associated with abdominal distension, and leakage of urine from the abdominal wound. Contrast studies suggested that the silicone catheter had migrated into the rectum and the child was re-explored.[bjuinternational.com]
Wide Neck
  • An oblique VCUG image reveals a large wide-neck diverticulum (*) arising from the prostatic urethra Click here to view Anterior urethral diverticulum An anterior urethral diverticulum is a saccular outpouching arising from the ventral surface of the anterior[ijri.org]
Burning Sensation
  • Both urethras were continent, and there was no complaint of a burning sensation or dribbling of urine during micturition. Physical examination revealed no other associated congenital abnormality. External genitalia were well developed.[ncbi.nlm.nih.gov]
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]
  • Patients may also present as urinary tract obstruction or chronic renal insufficiency.[read.nxtbook.com]
  • 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]
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

Chlamydia
  • Infection of your urethra is another cause - for example: Sexually transmitted infections such as gonorrhoea or chlamydia. Infection as a complication of long-term use of a tube (catheter) to drain your bladder.[patient.info]

Treatment

  • 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]
  • 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]
  • Holst et al. have described fulguration of an atypical urethra as another treatment option 11. Our treatment technique in this case was unique (minimally invasive) and successful.[f1000research.com]
  • Treatment of urethral duplication should be individualized based on the anatomic variant and also clinical symptoms and severity of anomaly. Some patients do not require treatment if they are free from infection and incontinence.[ncbi.nlm.nih.gov]

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]
  • . : 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]
  • 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]

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]
  • 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]
  • The etiology of urethral duplication is unclear, no hypothesis explains the basis for all cases 2, 3. Urethral duplication with the presence of a diverticulum is a rare combination and to the best of our knowledge has not been previously reported.[f1000research.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]
  • 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]

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]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology [ edit ] Ureteral development begins in the human fetus around the 4th week of embryonic development.[en.wikipedia.org]

Prevention

  • 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]
  • Attention and appropriate medical care can prevent many of these conditions. For your son, close attention is even more important. His situation might cause him no problems (some cases of double urethra are only noticed incidentally, late in life).[drgreene.com]
  • 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]
  • Surgery (usually via endoscopy) is done at time of diagnosis to prevent progressive renal deterioration.[merckmanuals.com]

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