Urethral duplication II-A Y type with rectal urethra: ASTRA approach and tunica vaginalis flap for first stage repair

Urethral duplication II-A Y type with rectal urethra: ASTRA approach and tunica vaginalis flap for first stage repair

Author Macedo Jr, Antonio Autor UNIFESP Google Scholar
Rondon, Atila Autor UNIFESP Google Scholar
Bacelar, Herick Autor UNIFESP Google Scholar
Ottoni, Sergio Autor UNIFESP Google Scholar
Liguori, Riberto Autor UNIFESP Google Scholar
Garrone, Gilmar Autor UNIFESP Google Scholar
Ortiz, Valdemar Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract INTRODUCTION: Urethral duplication is a rare congenital anomaly affecting mainly boys. Generally, the duplication develops on the sagittal plane; the accessory urethra may run dorsally or ventrally to the orthotopic one. We present a patient with urethral duplication in which the orthotopic urethra was patent in the penile segment but atresic in the bulbar and prostatic segment. The patient had urinary flow from the rectum and the ectopic urethra could be well identified by anal examination. MATERIALS AND METHODS: Age at surgery was 13 months. The procedure consisted of an ASTRA (anterior sagittal trans-ano-rectal) approach for dividing the urethra and rectum and was successful to move the urethra up to the perineal area. The rectum was reconstructed and the patient placed into a lithotomy position. A urethral catheter inserted in the penile urethra oriented us were the atresic urethra in bulbar area started. The scrotum was opened in the middle and the distance between the two urethral stumps proximal and distal defined the extension of no urethral tissue that consisted of 5 cm. We opened the right scrotal space and a tunica vaginalis flap was obtained and attached to the bulbar tissue for a two-stage urethroplasty strategy. RESULTS: Patient had a nice healing and the tunica vaginalis was nicely incorporated to the adjacent tissue, having the two urethral stumps well delineated. CONCLUSIONS: ASTRA approach in combination with a two-stage urethroplasty with tunica vaginalis dorsal flap proved to be an excellent combination for a rare case of urethral Y duplication having the main urethra into the rectum.
Language English
Date 2012-10-01
Published in International braz j urol. Sociedade Brasileira de Urologia, v. 38, n. 5, p. 707-708, 2012.
ISSN 1677-5538 (Sherpa/Romeo, impact factor)
Publisher Sociedade Brasileira de Urologia
Extent 707-708
Origin http://dx.doi.org/10.1590/S1677-55382012000500019
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000314419500020
SciELO ID S1677-55382012000500019 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/7337

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