Urethral stripping for delicate excision of dorsal accessory urethra

Abstract

Duplication of the urethra is a rare anomaly. The accessory urethra may be dorsal or ventral, relative to the orthotopic urethra. Dorsal urethral duplication describes a normally located meatus and another accessory epispadiac meatus. Excision of the dorsal accessory urethra is usually curative, on the condition that the ventral  orthotopic urethra is normal. However, most reports recommend surgery only when there are significant functional or cosmetic problems, for fear of possible damage to the neurovascular bundle, or the continence mechanism during surgical excision. In this  report, we describe a modification for excising the dorsal accessory channel by stripping with minimal disturbance to the glans. With continuous refinement of the  surgical technique together with more reports confirming its safety, we believe that total excision of the dorsal accessory urethra can be offered to more patients as being the standard level of care.

Keywords: accessory urethra, epispadias, urethral duplication