Espinosa-Chávez GB, Torres-Medina E, Muñoz-Islas EI, Vilchis-Cardenas M, Acosta-Garduño J

Language: Spanish
References: 13
Page: 22-25
PDF size: 296.77 Kb.

ABSTRACT

Introduction: Urethral duplication is a very rare congenital abnormality. Its clinical presentation varies according toits anatomical variant. It can be localized from the bladder neck to the distal part of the urethra and it can be complete or incomplete. It is most common at the sagittal plane with a ventral and dorsal urethra, the ventral urethra being the more functional. Management is generally complex and will depend on the type of urethral duplication. The case of a boy with Effmann classification Type II-AY urethral duplication is presented here.
Objective: To demonstrate total reconstruction of the urethra with oral mucosa graft and transverse dorsal preputial flap (Duckett technique) as definitive treatment method in patients with urethral duplication.
Clinical case: In a single surgical operation two approaches were carried out. First, anterior sagittal approach was used to dissect the urethra at the level of the prostatic urethra, isolating the ventral, or functional, urethra and anastomosing a six centimeter tubular oral mucosa graft up to the base of the penis distally at the midline. This was then followed by supine decubitus approach, degloving the prepuce and exposing the axis of the penis at its base. A seven centimeter tubular transverse dorsal preputial flap was proximally anastomosed to the oral mucosa graft up to the external urethral neomeatus at the tip of the glans. A 12 Fr urethral splint was left in place for twenty-one days. The urethral splint was removed on the twenty-first postoperative day, and micturition test was satisfactory. Cystotomy was left in place and removed after six months. Patient presently is without cystotomy catheter and has transurethral micturition. Vesicoureteral reflux was corrected and he continues to be under out-patient surveillance.

REFERENCES

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