An unobvious diagnosis: Rare variants of urethral duplication in boys
D. S. Tarasova,
D. A. Morozov,
O. L. Morozova,
A. S. Chubykina,
E. K. Ayryan,
M. I. Airapetyan,
O. V. Sukhodolskaya,
K. D. Morozov,
M. V. Popova,
A. A. Zagryanina https://doi.org/10.31146/2949-4664-apps-3-2-79-87
Abstract
Urethral duplication is a rare congenital malformation of the lower urinary tract, predominantly observed in male patients. The true level of incidence is unknown, with the respective publications remaining scarce and typically reporting isolated clinical observations. The variants of urethral duplication can be broadly classified into complete and incomplete forms. In complete duplication, both urethras exit separately from the bladder and open via their respective meatuses. Conversely, incomplete duplication features an accessory channel with only one opening, either at the distal end on the surface of the penis or in the proximal section, communicating with the main urethra. Incomplete urethral duplication is more common. The variability and frequency of clinical manifestations depend on the type of anomaly and the presence of complications. Verification of the duplication variant, particularly in the presence of a duplicated meatus, penile deformity, and a double stream of urine, is, as a rule, straightforward. Clinical variants associated with dysuric symptoms, recurrent urinary tract infections, urinary in- continence, or paraproctitis signs are significantly rarer and may pose challenges for timely diagnosis. Urethral duplications presenting with a paraurethral tract may remain asymptomatic for extended periods of time. Additional complexities arise from the lack of a versatile classification system, diagnostic algorithms, and surgical treatment strategies, which present serious challenges for pediatric surgeons and urologists dealing with this pathology. Most specialists typically rely on the classification of urethral duplication proposed by Effman (1976) and/or Williams — Kenawi and Mollard (1984). The Eff man classification is considered to be the most comprehensive and detailed. Therefore, in this article, we relied on this classification to describe clinical observations. Surgical treatment depends on the classification type and generally involves excision of the accessory urethra and reconstruction of the main urethra when needed. The treatment of IIA2-Y subtype presents the greatest challenges in terms of requiring perineal reconstruction, excision of the second urethra, and restoration of the main urethra anatomy. In this article, we present cases of IIA2-Y urethral duplication in boys.
About the Authors
D. S. Tarasova
I.M. Sechenov First Moscow State Medical University (Sechenov University); G.N. Speransky Children’s City Clinical Hospital No. 9
Russian Federation
Russian Federation
Darya S. Tarasova, Cand. Sci. (Med.), Assistant Professor, Department of Pediatric Surgery and Urology-Andrology named after L.P. Alexandrov; Pediatric Surgeon
Scopus Author ID: 57193897282
Research Author ID: P-4812-2018
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
29 Shmitovsky proezd, Moscow, 123317
D. A. Morozov
Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the N.I. Pirogov, Russian National Research Medical University
Russian Federation
Russian Federation
Dmitry A. Morozov, Dr. Sci. (Med.), Prof., Director; Chief Pediatric Surgeon of the Ministry of Health of the Russian Federation
Scopus Author ID: 56677459800
2, Taldomskaya str., Moscow, 125412
O. L. Morozova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Olga L. Morozova, Dr. Sci. (Med.), Prof., Department of Pathological Physiology
Scopus Author ID: 55805379800
Research Author ID: R-9125-2017
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
A. S. Chubykina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anna S. Chubykina, Resident, Department of Pediatric Surgery and Urology–Andrology named after L.P. Alexandrov
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
E. K. Ayryan
Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the N.I. Pirogov, Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University); G.N. Speransky Children’s City Clinical Hospital No. 9
Russian Federation
Russian Federation
Eduard K. Ayryan, Cand. Sci. (Med.), Researcher, Department of Pediatric Surgery; Assistant Professor of the L.P. Alexandrov Department of Pediatric Surgery and Urology–Andrology; Pediatric Surgeon
2, Taldomskaya str., Moscow, 125412
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
29 Shmitovsky proezd, Moscow, 123317
M. I. Airapetyan
Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the N.I. Pirogov, Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University); Moscow Multidisciplinary Clinical Center “Kommunarka”
Russian Federation
Russian Federation
Maxim I. Airapetyan, Cand. Sci. (Med.), Head of the Department of Pediatric Surgery; Assistant Professor of the L.P. Alexandrov Department of Pediatric Surgery and Urology–Andrology; Deputy Chief Physician for Pediatric Surgery
Scopus Author ID: 57208723820
2, Taldomskaya str., Moscow, 125412
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
8, bldg. 4 Sosensky Stan str., Moscow, 108814
O. V. Sukhodolskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University); Moscow Multidisciplinary Clinical Center “Kommunarka”
Russian Federation
Russian Federation
Olga V. Sukhodolskaya, Assistant Professor, Department of Pediatric Surgery and Urology–Andrology named after L.P. Alexandrov; Pediatric Surgeon
Scopus Author ID: 57226518828
Research Author ID: FT-1027-2023
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
8, bldg. 4 Sosensky Stan str., Moscow, 108814
K. D. Morozov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Kirill D. Morozov, Cand. Sci. (Med.), PhD Researcher, Department of Pediatric Surgery and Urology–Andrology named after L.P. Alexandrov, Pediatric Surgeon, Morozov Children’s City Clinical Hospital
Scopus Author ID: 57196955805
Research Author ID: OIT-3852-2025
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
M. V. Popova
G.N. Speransky Children’s City Clinical Hospital No. 9
Russian Federation
Russian Federation
Marina V. Popova, Pathologist
29 Shmitovsky proezd, Moscow, 123317
A. A. Zagryanina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anna A. Zagryanina, Six-year Student, N.F. Filatov Clinical Institute of Children’s Health
Research Author ID: OIT-3255-2025
2, bldg. 4 Bolshaya Pirogovskaya str., Moscow, 119991
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For citations:
Tarasova D.S., Morozov D.A., Morozova O.L., Chubykina A.S., Ayryan E.K., Airapetyan M.I., Sukhodolskaya O.V., Morozov K.D., Popova M.V., Zagryanina A.A. An unobvious diagnosis: Rare variants of urethral duplication in boys. Archives of Pediatrics and Pediatric Surgery. 2025;3(2):79-87. (In Russ.) https://doi.org/10.31146/2949-4664-apps-3-2-79-87
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