男性重复尿道二例报告并文献复习

Male urethral duplication：a two-case report and literature review

目的探讨男性重复尿道的临床特点和治疗方法。方法回顾性分析2011年6月及2014年4月收治的2例男性重复尿道患者的临床资料。例1，男，5岁，发现阴茎头排尿时两条尿线3个月就诊。例2，男，15岁，主诉阴茎勃起时背曲，阴茎背侧冠状沟处窦道并间断性尿样分泌物排出10余年。2例均行逆行尿道造影提示重复尿道，Effman分型为ⅡA2型。均在全麻下行阴茎背侧重复尿道切除术。结果2例患者术后病理报告均为镜下可见鳞状上皮单纯性增生及尿路上皮黏膜组织。例1随访1年，术后排尿通畅，单股排尿。例2随访6个月，仍有部分阴茎背曲，副尿道切除后无窦道分泌物。结论男性重复尿道罕见，临床表现和重复尿道的解剖分型相关，应根据解剖类型采用相应的个体化手术治疗。

Objective To summarize the clinical features and treatment of male urethral duplication.Methods The clinical data of 2 cases treated in June 2011 and April 2014 were analyzed retrospectively.The first case was a 5-year-old boy presented with passages of urine from two orifices in the penis.The second case was a 15-year-old boy presented with dorsal chordee and a sinus on the dorsum of the penis.The patient had a small amount of watery discharge occasionally dripping out of the opening for 10 years.The 2 patients underwent retrograde urethrography, which revealed a complete duplicated urethra with the channel arising from the proximal prostatic urethra （ class ⅡA2 according to the classification of Effman） .The 2 patients underwent excision of the accessory urethra under general anesthesia.Results The pathology reports of the 2 cases were hyperplasia of squamous epithelium and urothelial mucosa.Pathological diagnosis was urethral duplication.The first case was followed up for 1 year with a satisfactory functional and cosmetic outcome.The second case was followed up for 6 months and no watery discharge noticed from the residual dorsal chordee.Conclusions Urethral duplication is a rare congenital anomality affecting mainly boys.Clinical presentation varies depending on the different anatomical patterns of the urethral anatomy. Surgical management must be evaluated for each different anatomical variation.