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Accessory urethra with juxtaposed meatus
ACCESSORY URETHRA WITH JUXTAPOSED JOHN NABIL
F. REDMAN, K. BISSADA,
MEATUS
M.D. M.D.
From the Division of Urology, University Medical Center, Little Rock, Arkansas
of Arkansas
ABSTRACT - A case report is presented of a juxtaposed urethral meatus and accessory urethra. The need .for careful examination of the urethral meatus is emphasized.
Accessory urethras have been reported approximately one hundred times.“’ We could find no report of the accessory meatus being located in juxtaposition with the normal meatus. A patient with a side-by-side duplication of the urethral meatus and an accessory urethra is the basis of this report.
did not communicate with it (Fig. 2A,B). On passing a5 F catheter, entrance was made into the normal urethra, but this is believed to have been iatrogenic. Voiding cystography and excretory urography showed no other abnormalities. The urine was clear, and no surgical procedure was done to correct the accessory urethra.
Case Report A six-year-old black boy was referred to the Arkansas Children’s Hospital for surgical excision of a hydrocele on the right side. On examination of the urethral meatus two meati positioned side by side were noted (Fig. lA,B). The patient had been examined by several physicians who did not notice this anomaly. The child voided from the left meatus. A retrograde urethrogram of each urethra demonstrated a short accessory urethra which extended along side the normal urethra but
Comment The finding of a juxtaposed accessory urethral meatus, although an unusual finding, points up the need for careful examination of the urethral meatus in the male patient to render the physical examination complete. The method of examination by which this anomaly was discovered is the technique of grasping the glans on either side of the meatus and drawing out (Fig. 3). This maneuver allows for good visualization of the interior
FIGURE 1. (A) Juxtaposed urethral meati; (B) catheters
inserted in each meatus.
246
UROLOGY
/ FEBRUARY
1975 / VOLUME
V. NUMBER 2
FIGURE 2. (A) Dorsal view of simultaneuus retrograde urethrography of both ure thras; arrow indicates accessory urethra. (B) Arrow indicates junction of urethras on lateral view.
of the meatus and is useful in assessing the size of the meatus, identifying lesions of the meatus and fossa navicularis, and identifying accessory urethral openings or variants of hypospadias. It is submitted that the physical examination of every male patient should include careful examination meatus. Of_ the urethral 4301
West Markham Street
Little
Rock, Arkansas 72201 (DR. REDMAN)
References
FIGURE
3.
UROLOGY
Technique of examining urethral meatus.
/ FEBRUARY 1975 / VOLUME V. NUMBER 2
1. HARGIS,R. J.: Duplication of the male urethra. South. Med. J. 65: 146 (1972). 2. GROSS. R. E., and MOORE,T. C.: Duplication of the urethra: report of two cases and summary of the literature. Arch. Surg. 60: 749 (1950).
F. REDMAN, K. BISSADA,
MEATUS
M.D. M.D.
From the Division of Urology, University Medical Center, Little Rock, Arkansas
of Arkansas
ABSTRACT - A case report is presented of a juxtaposed urethral meatus and accessory urethra. The need .for careful examination of the urethral meatus is emphasized.
Accessory urethras have been reported approximately one hundred times.“’ We could find no report of the accessory meatus being located in juxtaposition with the normal meatus. A patient with a side-by-side duplication of the urethral meatus and an accessory urethra is the basis of this report.
did not communicate with it (Fig. 2A,B). On passing a5 F catheter, entrance was made into the normal urethra, but this is believed to have been iatrogenic. Voiding cystography and excretory urography showed no other abnormalities. The urine was clear, and no surgical procedure was done to correct the accessory urethra.
Case Report A six-year-old black boy was referred to the Arkansas Children’s Hospital for surgical excision of a hydrocele on the right side. On examination of the urethral meatus two meati positioned side by side were noted (Fig. lA,B). The patient had been examined by several physicians who did not notice this anomaly. The child voided from the left meatus. A retrograde urethrogram of each urethra demonstrated a short accessory urethra which extended along side the normal urethra but
Comment The finding of a juxtaposed accessory urethral meatus, although an unusual finding, points up the need for careful examination of the urethral meatus in the male patient to render the physical examination complete. The method of examination by which this anomaly was discovered is the technique of grasping the glans on either side of the meatus and drawing out (Fig. 3). This maneuver allows for good visualization of the interior
FIGURE 1. (A) Juxtaposed urethral meati; (B) catheters
inserted in each meatus.
246
UROLOGY
/ FEBRUARY
1975 / VOLUME
V. NUMBER 2
FIGURE 2. (A) Dorsal view of simultaneuus retrograde urethrography of both ure thras; arrow indicates accessory urethra. (B) Arrow indicates junction of urethras on lateral view.
of the meatus and is useful in assessing the size of the meatus, identifying lesions of the meatus and fossa navicularis, and identifying accessory urethral openings or variants of hypospadias. It is submitted that the physical examination of every male patient should include careful examination meatus. Of_ the urethral 4301
West Markham Street
Little
Rock, Arkansas 72201 (DR. REDMAN)
References
FIGURE
3.
UROLOGY
Technique of examining urethral meatus.
/ FEBRUARY 1975 / VOLUME V. NUMBER 2
1. HARGIS,R. J.: Duplication of the male urethra. South. Med. J. 65: 146 (1972). 2. GROSS. R. E., and MOORE,T. C.: Duplication of the urethra: report of two cases and summary of the literature. Arch. Surg. 60: 749 (1950).