title: Urethral duplication--a wide spectrum of anomalies.
abstract: OBJECTIVE
  Urethral duplications are rare lower urinary tract anomalies, with multiple anatomical variants described. This paper aims to separate this complex anomaly into different diseases, each with distinct clinical forms according to the disturbance during embryogenesis, yet noting a few similarities that may be helpful in their management. The classification system of urethral duplication is also discussed.
  
  
  METHODS
  Twelve urethral duplication cases over a 14-year period were reviewed. Clinical presentation, the imaging studies used to ascertain anatomical details, type of urethral duplication and surgical correction used in the treatment of patients are presented.
  
  
  RESULTS
  Nine patients had urethral duplication in the sagittal plane and three patients in the coronal plane. Of the patients with sagittal urethral duplication, 3 had pre pubic sinus, 3 had epispadiac urethral duplication, 1 had a dorsal urethral duplication deviated from the midline and 2 had hypospadiac urethral duplication. All the patients with coronal urethral duplication had associated bladder duplication. The surgical correction of the patients with sagittal urethral duplication included excision of the pre pubic sinus, excision of the duplicated urethra, and urethroplasty. Excision of the hemibladders' septum and closure of one bladder neck was the treatment for patients with coronal urethral duplication and bladder duplication.
  
  
  CONCLUSIONS
  Urethral duplication is a complex anomaly and the different manifestations probably have different embryological origins. Each group, sagittal or coronal, has a few similarities that may be helpful in their management, although every diagnosed case presents a unique anatomy and surgical treatment must be individualized.
authors.affiliation: Hospital Infantil Darcy Vargas, Pediatric Urology Division, São Paulo, Brazil. Electronic address: lucianosonofre@yahoo.com.br.
authors.forename: Luciano Silveira
authors.initials: LS
authors.lastname: Onofre
authors.forename: Adriano Luis
authors.initials: AL
authors.lastname: Gomes
authors.forename: Jovelino Quintino de Souza
authors.initials: JQ
authors.lastname: Leão
authors.forename: Fernanda Ghilardi
authors.initials: FG
authors.lastname: Leão
authors.forename: Tayane Magalhães Amaral
authors.initials: TM
authors.lastname: Cruz
authors.forename: Jose
authors.initials: J
authors.lastname: Carnevale
mesh_terms: D001003:Anal Canal / Q000002:abnormalities / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012007:Rectum / Q000002:abnormalities / Q000601:surgery; D012189:Retrospective Studies; D014521:Urethra / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D014522:Urethral Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001743:Urinary Bladder / Q000002:abnormalities / Q000601:surgery; D014567:Urography; D013520:Urologic Surgical Procedures; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
keywords: Abnormalities; Surgical approach; Urethra; Urethral duplication