Multiple hypoplastic duplicated urethral hydrodistension and simple end-to-end anastomosis to penoscrotal hypospadias: a novel technique.

Complete urethral duplication is a rare congenital genitourinary anomaly with various symptoms. Since anatomical place of urethra greatly varies between cases, surgical management of the patients is personalized according to the type of the duplication and requires a careful workup before planning for any intervention. In this case report, a 4-year-old boy with finding of complete proximal hypospadiac urethral duplication is presented with double-stream voiding. He was passing a normal stream of urine through the hypospadiac tract, while a thin stream came out from the normal meatal site. Examination revealed a hypoplastic orthotopic urethra with an accessory penoscrotal hypospadiac urethra. The patient was successfully managed with hydrodistension technique which was used to resolve the stricture of hypoplastic dorsal urethra followed by end-to-end anastomosis to penoscrotal hypospadias. This approach gives an insight that the technique could be possibly considered as a simple alternative to avoid proximal hypospadias repair which is comparatively a challenging surgical task.