Case reportBladder exstrophy associated with complete urethral duplication: Bladder can be augmented with dorsal urethral mucosa

Abstract

Bladder exstrophy associated with complete urethral duplication is very rare with only 8 reported cases in the English literature. This is a report of a16 years old boy who had originally been diagnosed with only bladder exstrophy but was discovered to have a normal ventral urethra intra-operatively during penile disassembly. The mucosa of the dorsal urethral plate was transected at the corona and mobilised proximally to augment the bladder. The ventral urethra was preserved and the bladder closed. At 14 months follow up he is voiding normally, has adequate bladder capacity and a normal penis. Post operative voiding cystogram shows bilateral grade 2 vesicoureteric reflux. In conclusion, bladder exstrophy with urethra duplication is rare and the diagnosis usually missed. The mucosa of the dorsal urethral plate can be preserved and used to augment the bladder.

Keywords: Bladder exstrophy; Urethral duplication; Bladder augmentation; Urinary incontinence

African Journal of Urology (2013) 19, 99–101