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Radiological Case of the Month

John R. Sty, MD; Donald P. Babbitt, MD; Lionel W. Young, MD
Am J Dis Child. 1982;136(3):265-266. doi:10.1001/archpedi.1982.03970390079020.
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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


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