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      Congenital anomalies of the male urethra

      review-article
      , ,
      Pediatric Radiology
      Springer-Verlag
      Male urethra, Anomalies, Embryology, Congenital

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          Abstract

          The spectrum of congenital anomalies of the male urethra is presented. The embryologic basis of each anomaly, when known, is discussed. Clinical and imaging features of each entity are presented.

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          Most cited references51

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          Duplication of the urethra.

          Ten patients with patent urethral duplication are presented. Nine patients had two independent patient channels originating from the bladder or the posterior urethra. Both voiding cystourethro and retrograde urethrography are necessary to completely evaluate this anomaly. In each instance the ventral channel, regardless of the position of its meatus, proved to be the more functional urethra. In those patients whose dorsal channel was in an epispadiac position, the symphysis pubis was abnormally wide. A functionally and anatomically accurate classification is proposed, and the embryology of these anomalies is discussed.
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            Urethral duplication in the male: review of 16 cases.

            Urethral duplication is a rare congenital anomaly. The clinical presentation varies because of the different anatomical patterns of this abnormality. We describe our experience with 16 male patients with this anomaly. We retrospectively reviewed the records of 16 male patients treated for urethral duplication in the last 10 years. Age at presentation ranged from newborn to 8 years. Evaluation included ultrasound, voiding cystourethrography, retrograde urethrography and endoscopy. A blind ending duplicated urethra (type I) was present in 4 patients, 2 independent urethras with distinct bladder necks (type IIA1) in 6, 2 urethras originating from a common bladder neck (type IIA2) in 4, and complete urethral and bladder duplication (type III) in 2. Six patients had associated vesicoureteral reflux. Duplication was an incidental finding at epispadias repair in 3 patients with bladder exstrophy, at hypospadias repair in 1 and at hydrocele repair in 1. One patient with bilateral dysplastic kidneys died in the newborn period. Surgical management included excision of the duplicated urethra in 8 cases and urethroplasty using a pedicle flap in 2, while surgical management was not required in 3. Urethral duplication is a rare congenital anomaly with a variable clinical presentation. This pathological condition may easily be under diagnosed, especially in patients with other associated anomalies, such as hypospadias or bladder exstrophy. Surgical management should be planned individually according to the anatomical findings of the abnormality.
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              The anatomy and embryology of posterior urethral valves.

              We reviewed the literature to better elucidate the history behind our understanding of the anatomy, classification and embryology of posterior urethral valves. A directed MEDLINE literature review of the anatomy, classification and embryology of posterior urethral valves was performed. An effort was made to focus on the most frequently cited historical articles as well as those including detailed anatomical analyses of fetal specimens. Also included was the analysis of a specimen obtained at our institution in a novel manner that to our knowledge has not been previously described in the literature with respect to the anatomy of posterior urethral valves. The precise origins regarding the anatomy and embryology of posterior urethral valves remain undefined. However, the literature is abundant in theories regarding the origin of posterior urethral valves, based primarily on small uncontrolled series or case reports. There are a limited number of reports of the anatomy of posterior urethral valves in methodical fashion using reproducible scientific techniques such as histopathology. These reports are invaluable for providing a foundation of how to properly study and define the origins of posterior urethral valves. Elucidating this most fundamental feature of a congenital condition central to the practice of pediatric urology is essential. More well designed studies specifically with this goal in mind are necessary. Incorporating new reconstructive imaging modalities may assist us in pinpointing the elusive origins of the embryology and anatomy of posterior urethral valves.
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                Author and article information

                Contributors
                jebl1@optonline.net
                Journal
                Pediatr Radiol
                Pediatric Radiology
                Springer-Verlag (Berlin/Heidelberg )
                0301-0449
                1432-1998
                22 May 2007
                September 2007
                : 37
                : 9
                : 851-862
                Affiliations
                Department of Radiology, Children’s Hospital at Montefiore Medical Center, 714 Forest Ave, Mamaroneck, NY 10543 USA
                Article
                495
                10.1007/s00247-007-0495-0
                1950215
                17572890
                7cb05293-f062-4afb-85ef-25a74549573f
                © Springer-Verlag 2007
                History
                : 27 December 2006
                : 15 March 2007
                : 6 April 2007
                Categories
                Review
                Custom metadata
                © Springer-Verlag 2007

                Pediatrics
                congenital,embryology,anomalies,male urethra
                Pediatrics
                congenital, embryology, anomalies, male urethra

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