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Case Reports
. 2017 Feb 24:2017:bcr2016217331.
doi: 10.1136/bcr-2016-217331.

Rare association of congenital penile urethrocutaneous fistula with Y-type urethral duplication

Ashok Kumar Gupta  1 , Manoj Kumar  1 , Kawaljit Singh  1 , Ashok Kumar Sokhal  1
Affiliations
Case Reports

Rare association of congenital penile urethrocutaneous fistula with Y-type urethral duplication

Ashok Kumar Gupta et al. BMJ Case Rep. .

Abstract

A 24-year-old man presented with symptoms of difficulty in passage of urine, mixed with gas and stool from penoscrotal junction since birth. He had a history of surgery (posterior sagittal anorectoplasty) for imperforate anus in first week of his life. On physical examination, external meatus was adequate with small 5×5 mm fistulous opening noted at penoscrotal junction with normal anal tone and opening. On evaluation with retrograde urethrography, voiding cystourethrogram, cystoscopy and barium enema, he was found to have penile urethrocutaneous fistula of 0.5×0.5 cm with Y-type incomplete urethral duplication. Urethroanal fistula (Y-type urethral duplication) was of small size (<5 mm), so closed primarily through perineal route with interposition of ischiorectal fat. Penile urethrocutaneous fistula (4 mm) too was closed primarily and covered with tunica vaginalis flap in single sitting. It has been 6 months since surgery and the patient is fully continent and voiding well with no urinary or faecal leak.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Normal glanular external meatus with small 5×5 mm fistulous opening noted at penoscrotal junction.
Figure 2
Figure 2
RGU through orthotropic meatus, showing urethrocutaneous fistula at penoscrotal junction and urethrorectal fistula between proximal bulbar urethra and anal canal. RGU, retrograde urethrogram.
Figure 3
Figure 3
RGU through penoscrotal fistula, showing narrow lumen penile urethrocutaneous fistula and urethrorectal fistula between proximal bulbar urethra and anal canal. RGU, retrograde urethrogram.
Figure 4
Figure 4
VCUG showing normal bladder neck, single proximal urethral channel with incomplete type urethral duplication. VCUG, voiding cystourethrogram.
Figure 5
Figure 5
Fistulous tract excision through a midline perineal incision after putting a 10 French infant feeding tube from urethra to anus through the fistulous tract.
Figure 6
Figure 6
Circumferential incision around external fistulous opening at penoscrotal junction and excision of fistulous tract.
See this image and copyright information in PMC

References

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