Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S3: SPECIAL SESSION ON CASE

PRESENTATION

Moderators: Ramnath Subramaniam (UK), Hillary Copp (USA)

Parallel session with S2.

ESPU Meeting on Wednesday 14, October 2015, 15:35 - 17:00

15:35 - 15:38

S3-1

(CP)

THREE CASES OF URETHRAL DUPLICATION IN GIRLS ASSOCIATING ONE

HYPOSPADIC AND ONE EPISPADIC URETHRA

Eric DOBREMEZ

, Aurore BOUTY

and Luke HARPER

1) CHU de BORDEAUX, Pediatric Surgery, Bordeaux, FRANCE - 2) Royal Children's Hospital, Pediatric Urology,

Melbourne, AUSTRALIA - 3) CHU La Réunion, Pediatric Surgery, Saint Denis De La Réunion, FRANCE

PURPOSE

We report three cases of urethral duplication in girls, treated over a 30-year period. Such malformation is extremely

rare, with less than 40 cases in the literature. The clinical presentation in our cases was particular because of abnormal

location of both urethras.

MATERIAL AND METHODS

The first case was diagnosed following discovery of an abdominal mass at birth, whilst the second case had a prenatal

diagnosis of pelvic cystic mass. In both cases, clinical examination, sonography and cystography showed an accessory

epispadiac urethra placed above a bifid clitoris, a functional hypospadiac urethra opening in the hymen, hydrocolpos and

bilateral ureterohydronephrosis. The last case externally presented as a urogenital sinus at birth. The epispadic urethra

was diagnosed at genitography, because he was very narrow. For theses three girls, pubic symphisis was normal and

there were no other associated anomalies.

RESULTS

In two first cases, vaginal dilatation was performed to resolve the hydrocolpos and improve urinary retention and

ureterohydronephrosis. The epispadic urethra was later removed through a local incision. In the second case, further

partial urogenital mobilization was necessary to improve voiding. The last case was treated by complete urogenital

mobilization, to open separately the vagina and the urethra. The first girl is healthy, despite renal hypotrophy, with

normal continence, menstruation and intercourse. The second one presents persistent lower urinary tract infections, due

to persistent voiding difficulties. The last is too young to experience continence.

CONCLUSIONS

These cases with both urethras in an ectopic location are very rare. All cases presented with genital retention.

Treatment has to deal with the incontinent accessory urethra and the obstructive hypospadic one.