ORIGINAL ARTICLE   

Minerva Urologica e Nefrologica 2020 April;72(2):229-35

DOI: 10.23736/S0393-2249.19.03271-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Urethral duplication in male epispadias: a very uncommon association

Paolo CAIONE ¹, Rossella ANGOTTI ² ✉, Francesco MOLINARO ², Chiara PELLEGRINO ², Marianna SCUGLIA ¹, Simona GEROCARNI NAPPO ¹, Mario MESSINA ²

¹ Division of Pediatric Urology, Bambino Gesù Children’s Hospital, Rome, Italy; ² Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

BACKGROUND: Urethral duplication associated with epispadias is a rare malformation. Few cases are described in Literature. We report the experience of two centers to add to the literature.
METHODS: A retrospective study was conducted in two Italian Centers. All patients with urethral duplication associated with epispadias, treated from 1997 to 2017 were included. The preoperative work-up included renal-urinary ultrasonography and voiding cystourethrogram. All patients underwent surgery according to the Mitchell-Caione technique. Cosmetic result, urinary continence and satisfaction degree of patients at the last follow-up were evaluated as outcomes. Six male patients with urethral duplication in epispadias were included. Two patients presented penile epispadias and four penopubic epispadias. Only one patient had urinary incontinence as presenting symptomatology. The diagnosis of urethral duplication was accidental during preoperative evaluation in the remaining five patients.
RESULTS: At last follow-up (mean 8.3 years) all patients but one presented good cosmetic result, one patient presented mild stress urinary incontinence, one presented nocturnal enuresis. The physical genital appearance was improved in all patients. Urethral duplication in association with epispadias is a rare urogenital abnormality. No classification is universally accepted.
CONCLUSIONS: Based on our experience, we believe that the presence of any duplication should be carefully searched during surgery for male epispadias.

KEY WORDS: Epispadias; Child; Urethral diseases