MRI in congenital duplication of urethra

Abstract

Congenital urethral duplication is a rare anomaly, with less than 200 cases described in the literature. The investigations that are usually performed are micturating cystourethrography (MCU) and retrograde urethrography (RGU), which can diagnose the presence of duplication but cannot diagnose the precise relationship of the duplicated urethra with other pelvic structures. MRI, because of the excellent tissue contrast that it provides and its multiplanar ability, can demonstrate with precision, the size, shape and position of the two urethras. We describe below a case where MRI was able to show this exquisitely.

<p>Complete Urethral Duplication: Case Report and Literature Review</p>

“…Images from the ceVUS demonstrated a distinct linearity arising dorsally from the posterior urethra that partially opacified with contrast which was confirmed an urethral duplication by VCUG. Bhadury S et al also used MRI, 15 which allows excellent tissue contrast and can provide multi-planar scans, to demonstrate the precise size, shape and position of the two urethras in one patient.…”

Urethral Duplication with a Cystic Phallic Urethra Associated with a Uterus Didelphys, Partial Agenesis of the Tibia, and an Equinovarus Foot

“…The male urethral duplication is divided into three types according to Effman's classification [3]. In girls, a classification of 5 types has been proposed [4]:Type I: double urethra and double bladderType II: double urethra with single bladderType III: accessory urethra posterior to the normal channelType IV: double proximal urethra and single distal urethraType V: single proximal urethra and duplicated distal urethra.…”

“…According to them, an abnormal relationship exists between the lateral anlagen of the genital tubercle and the ventral end of the cloacal membrane. [1, 4, 6]. The opening of the urethra in the vagina corresponds to a defect of the urethrovaginal septum which may be total, allowing a direct communication of the bladder with the vagina, or more frequently partial [2].…”

“…MRI provides a more accurate malformation assessment for the evaluation of urethral duplication by precisely demonstrating the sizes, shapes, and positions of both urethras as well as the existence of other genitourinary anomalies [1, 4]. But it is not always available or in our context.…”

Urethral duplication: Experience of four cases

“…[1–4] It may be complete or incomplete. The accessory urethra often presents as dorsal or ventral midline openings and rarely opens eccentrically (Coronal/collateral).…”