Radiological Case of the Month

A newborn male infant was noted to have intermittent straw-colored liquid passing from the rectum. The physical examination showed no abnormalities, including in the genitalia, with the exception of a small urethral meatus. A retrograde urethrogram was performed to evaluate the lower urinary tract (Fig 1).

Denouement and Discussion  Urethral Duplication: Perineal UrethraThis male infant was examined urethrographically because of the possibility of rectourethral fistula. The findings represent duplication of the urethra. Urethral duplication is a rare congenital anomaly, apparently initially described by Aristotle.¹ Since that early description, fewer than 150 cases have been reported.²There are three main anatomical variations: (1) complete duplication: the accessory urethra arises from the bladder and extends distally to the external orifice in the penis; (2) bifid urethra: the accessory urethra arises from the primary urethra; (3) perineal urethra: the accessory urethra arises from a separate opening in the bladder or proximal urethra