UNASSIGNED: Urethral duplication is a congenital anomaly characterized by the partial or full development of an auxiliary urethra as a second urethral channel varying in extent and location. The course of treatment for urethral duplication should be individualized for each patient based on the type of anomaly and the existence of symptoms. In most cases, if the ventral orthotopic urethra is normal, excision of the dorsal auxiliary urethra is almost always curative.
METHODS: We report a case of a 13-year-old boy who presented with recurrent urinary tract infection, occasionally having drops of urine at an external pin hole meatal opening on the dorsum of the penile shaft. Several investigations were performed to confirm the presence of the dorsal accessory urethra. The patient underwent complete excision of the accessory urethra, and 12 weeks post-surgery the patient was completely asymptomatic.
CONCLUSIONS: Urethral duplications are rare anomalies. These anomalies have been classified in various ways in the literature, including sagittal and lateral duplications, dorsal and ventral duplications. The sagittal plane is where the majority of urethral duplications occur. Based on the anatomic variation, clinical presentation and severity of the anomaly, urethral duplication treatment should be customized for each patient. An asymptomatic child may require no specific treatment. Total surgical excision of the dorsal accessory urethra appears to offer the best curative solution.
CONCLUSIONS: Excision of the dorsal accessory urethra is usually curative when the ventral orthotopic urethra is normal. Thorough investigation before surgery is mandatory to determine the type of urethral duplication. The most common diagnostic procedures for urethral duplications include cystoscopy, KUB ultrasonography, and micturating cystourethrography. These procedures can help plan surgery, prevent complications such as neurovascular bundle injuries and urine incontinence, and improve patient self-esteem and quality of life.

Urethral duplication is a diverse spectrum of disease having multiple anatomic variants. The clinical presentation varies from being asymptomatic to recurrent urinary tract infections. A high level of clinical suspicion and awareness among primary caregivers is needed to make a proper diagnosis. All patients presenting with any sort of penile deformity or abnormality of the urinary stream should be evaluated to rule out this condition. In this case report the patient had presented with the urinary stream being directed towards his abdomen due to abnormal dorsal curvature of the penis which was due to tethering of the accessory urethra.

To report a novel maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 urethral duplication (UD).
A 3-years-old boy was referred to our institute for abnormal appearance of genitalia. Physical examination revealed an epispadiac meatus on the dorsum of the penile shaft, in addition to the orthotopic meatus at the tip of glans. He can void through both urethrae with continence (grade I). Voiding cystourethrography and the cystoscopy confirmed the Type IIA1 UD with two urethrae arising independently from the bladder neck. A novel maneuver of end-to-side urethro-urethrostomy transferring the dorsal urethra through the corpus cavernosa and anastomosing it to the posterior wall of the ventral urethra was successfully performed.
The urethral catheter was removed 2 weeks postoperatively. Neither urethral stricture nor fistula was noticed. After 1 year of followed-up, the boy can void fluently with continence (grade I). The Qmax was 10.4 ml/s.
Our maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 UD was safe and effective, especially for the continent cases with the ectopic meatus on the penile shaft.

Urethral duplication is a rare anomaly with varying clinical manifestations. About 300 cases have been reported till date and are often associated with genitourinary (GU) and gastrointestinal (GI) tract anomalies. A 6-day-old neonate presented with an absent anal opening and a tiny perineal fistula having slight meconium staining. He did well after anoplasty. Low anorectal malformation (ARM) has been reported as the GI anomaly associated with urethral duplication. However, an ectopic scrotum as the principal GU tract anomaly associated with urethral duplication is being reported for the first time in literature with probable embryologic explanation. The GU tract anomalies were successfully repaired surgically later in infancy.

Urethral duplication are rare anomalies of the lower urinary tract consisting of partial or complete development of an accessory urethra that common in males than female. The exact embryological mechanism for this condition remain unclear, it is thought to relate to a disruption of development of the lateral folds of Rathke during hindgut development. There are 3 types based on Effman\'s classification. Diagnosis of urethral duplication, a genital examination has to performed and confirmed by micturating cytourethrography and retrograde urethrography. The authors presented a case of 67-year-old man complaining of dysuria, who was diagnosed with urethral duplication Effman Classification type IIB accompanied by bulbar urethral stricture and diverticula and multiple bladder diverticula after performing retrograde urethrography and micturating cystourethrography. This is an extremely rare type of duplication of the urethra (type IIB) with late presentation. Further study may be required regarding the surgical management.

Urethral duplication is a rare disease with diverse clinical symptoms and more common in male; only fewer than 300 instances have been reported. In this case report, a 20-year-old male patient came to the urology polyclinic with two holes on the glans penis, accompanied by daily clear discharge in the upper hole. This complaint has been experienced since birth. The patient underwent an excision of the dorsal accessory urethra to correct penile anomalies.

Duplication of urethra is a rare congenital anomaly; a Y-shaped urethral duplication is the rarest variant and lacks a standardised treatment plan. We report a nine-year-old male patient with a Y-duplication of urethra diagnosed during neonatal age who presented to a tertiary care teaching hospital in India in 2018. The patient had undergone a vesicostomy on the seventh day of life for passing urine per anus and was lost to follow-up thereafter. At eight years of age, there was a failed attempt at disconnection of the duplicated urethral tract from the anus after colostomy. The patient was managed successfully by progressive dilatation of the orthotopic urethra, which required multiple stages, followed by separation of the urethra from the rectum. At three-years follow-up the patient was continent and asymptomatic.

Duplication of the urethra is a rare congenital malformation. A 14-month-old, sexually intact, male, Lagotto dog with complete Y-type urethral duplication was subjected to accessory urethra treatment for cystoscopic guided laser cauterization, with a 10-Watt diode laser with 550-micron fiber and 2.3 Fr outer diameter. The laser cauterization, that was repeated every 14 days for a total of three times, was performed by inserting the instrument from the accessory urethra outlet in the perianal area until it could be seen by the urethroscope, inside the ischial urethra. Nevertheless, this technique that proved to be non-invasive, less expensive than surgery, of short duration, and safe, did not allow the complete closure of the abnormal urethral tract. Therefore, the subsequent surgical removal of the accessory urethra was carried out. To the authors\' knowledge this is the first report on the use of cystoscopic guided diode laser cauterization for accessory urethra treatment.

Urethral duplication is uncommon with few cases reported in the literature. We report a case in which a patient presented with discharge from proximal part of penis since childhood and recent history of infection. The diagnosis of pre-pubic sinus was made and complete excision of the sinus tract was done.

Urogenital sinus (UGS) and cloacal malformations are the spectra of disease affecting mainly females, resulting in an unusual confluence of the genital and urinary tract with or without the involvement of the gastrointestinal tract. Successful reconstruction of these anomalies depends on the accurate preoperative delineation of abnormal anatomy with the help of cross-sectional and other contrast studies like genitourogram along with cystourethroscopy wherever indicated. We hereby report a case of a 14-year-old female who presented with irregular cyclical hematuria and was diagnosed with persistent UGS with urethral duplication. After a thorough evaluation, the patient was successfully managed with surgical reconstruction, described in this study. Persistent UGS is a complex developmental anomaly. Complete characterization of anomaly requires a thorough evaluation such as hormonal assessment, endoscopy, cross-sectional, and radiological contrast study. Surgical reconstruction needs individualization and may need clitoroplasty, labioplasty, and urethral and vaginal mobilization. Morphological and functional outcome is satisfactory in a well-planned surgical reconstruction.