The proximal portion of the penile urethra, the bulbar urethra, is dilated and is the site of drainage of cowpers ducts. Congenital urological anomalies abnormalities are birth defects involving the urological and genital systems or genitourinary system. The urethroplasty involves division of the short urethra and the design of an island flap using penile skin formed into a. The diagnosis was made by exclusion of the inflammatory and traumatic causes. We report a case of a 16 month old male child with duplication of the urethra and diverticulum arising from the ventral urethra. Congenital urinary anomalies may be symptomatic or encountered during imaging for other clinical indications. Congenital urethral stricture congenit stricture of. Normal urethral anatomy is shown p prostatic urethra, short arrow incisura, long arrow verumontanum. Diagnosis and management of pediatric urethral injuries fulltext. In three cases the stricture was located in the bulbar and in four cases in the penile urethra.
Jul 15, 2015 congenital abnormalities of the kidney and urinary tract these problems usually required surgical correction. Congenital abnormalities of the female reproductive tract. This book discusses as well the etiology, pathology, and treatment of various diseases of the urethra, including acute urethritis, stricture of the urethra, periurethritis, tumors of the urethra, and schistosomiasis of the urethra. Congenital anomalies of the male urethra springerlink. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Congenital anomalies of the urogenital tract are among the commonest anomalies found in the fetus, neonate, and infant. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect.
Affected bulls are unable to protrude the penis from the sheath and, in most cases, cannot achieve intromission. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Congenital anomalies of the male urethra include various anomalies due to complex development of urethra. Ppt congenital anomalies powerpoint presentation free to. Aug 04, 2011 duplication of urethra is a very rare condition where there is an extra urethra, instead of the normal one. Virtually always unilateral 1 in 1,000 to 1 in 2,000 births. Some authors have stated that urethral valves occur exclusively in males 2, 6, but others have indicated that the lesions may rarely be encountered in females 35, 7. These urinary tract defects can involve different parts of the genitourinary system as well as other organ systems. The spectrum of congenital anomalies of the male urethra is presented. It is the most common cause of bladder outlet obstruction in male newborns. Prostatic utricle is a small pouch arising from the prostatic urethra at the level of the. The entity needs degloving with chordectomycorporoplasty urethroplasty. A 11dayold male term infant of an uncomplicated pregnancy presented with fever initially thought to be secondary to an upper.
E congenital short urethra normally developed urethra but short in length true congenital short urethra, which needs urethral reconstruction f complex chordee association of fibrous chordee with or without corporocavernosal chordee, and or congenital short urethra. Among gram positive organisms, in contrast, staphylococcus aureus uncommonly causes cystitis and ascending pyelonephritis, whereas staphylococcus saprophyticus, which adheres significantly better to uroepithelium than do staphylococcus aureus or staphylococcus epidermidis, is a frequent cause of lower urinary tract infections. The midportion of the penile urethra is tethered superiorly by the suspensory ligament 5. Discussion the surgical correction of congenital chordee penis is complex and based primarily on the thorough and accurate removal of all visible dysplastic. Congenital abnormalities of the kidney and urinary tract these problems usually required surgical correction. Congenital means they occur during fetal development or very early in infancy. In girls, the urethra opens between the clitoris and labia or in the abdomen. Objective to determine whether there are two distinct types of congenital obstruction of the proximal urethra.
Congenital anterior urethral diverticulum in the male. Management of female congenital short patulous urethra with. Penile and urethral anomalies pediatrics merck manuals. Congenital posterior urethral valves are a common cause of severe lower urinary tract obstruction in young males 4, 6. It almost always occurs in boys, is usually acquired, and typically results from a crush injury after straddle trauma. This defect is usually referred to as a congenital posterior urethroperineal fistula cupf. Pages in category congenital disorders of urinary system the following 26 pages are in this category, out of 26 total. The reconstructed segment is placed between two divided segments of the original short urethra and restores its natural length. The penile urethra might be normal, or additional urethral anomalies such as megalourethra, urethral atresia or coexisting posterior urethral valves can be present. Posterior urethral valve puv disorder is an obstructive developmental anomaly in the urethra and genitourinary system of male newborns. May 22, 2007 the spectrum of congenital anomalies of the male urethra is presented. Management of female congenital short patulous urethra. Request pdf management of female congenital short patulous urethra with urethral tapering and pubovaginal sling. The cloaca is divided into the urogenital sinus and the hindgut by the urorectal septum, which descends in a rostraltocaudal fashion fig.
Any information contained in this pdf file is automatically generated from. The array of abnormalities is related to the embryologic stage at the time of the developmental insult, and these abnormalities result in a spectrum of conditions ranging from insignificant to incompatible with life. Most of these anomalies can be easily diagnosed by conventional contrast voiding cystourethrogram vcug, retrograde urethrogram rgu, intravenous urography ivu, or nuclear imaging, and can be successfully treated with a good outcome. Congenital lower urinary tract obstruction luto comprises a heterogeneous group of pathologies causing obstruction to the urethra, the most common being posterior urethral valves. Classic y urethral duplication has a small dorsal urethra and a large ventral one. Ppt congenital anomalies powerpoint presentation free. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Congenital anomalies of urinary system in children. Bulls may breed satisfactorily in the first season, but copulation becomes impossible as their body size increases.
Wikimedia commons has media related to congenital diseases and disorders of urinary system. For claims with a date of service on or after october 1, 2015, use an equivalent icd10cm code or codes. Duplication of the urethra is a rare congenital anomaly. Congenital anomalies of the kidney and urinary tract cakuts occur in 36 per live births, account for the most cases of pediatric endstage kidney disease eskd, and predispose an individual to hypertension and cardiovascular disease throughout life. These mechanisms include an abortive attempt at urethral duplication, failure of alignment of the proximal and distal urethra, imbalanced tissue growth, and congenital cystic dilatation of the periurethral glands. The results obtained were good, with a followup of 5 to 50 months.
P prostatic urethra, short arrow incisura, long arrow verumontanum full size image. Pdf a new algorithm for management of chordee without. Regardless of the cause, patients present with varying degrees of obstruction that may range from mild to lifethreatening. The prepuce at the dorsum is in part deficient, and bound to the glans around the abnormal orifice. A surgical technique is described for the short urethra.
The cause of congenital anorectal malformations is unknown, although environmental factors such as drug use during pregnancy may play a part. Clinical and imaging features of each entity are presented. Most common congenital abnormality of male external genitalia other than cryptorchidism urethra opens onto ventral surface of penis or scrotum 3 5 live male births due to failure of fusion of urethral folds. Symptoms and signs of epispadias are incontinence, reflux, and utis. Urethral duplications can be classified into three types. Pdf the spectrum of congenital anomalies of the male urethra is presented.
The congenital obstructive lesions in the bulbar urethra, named type iii valves by young in 1919, have been eponymously referred to as cobbs collar or moormans ring. The urethroplasty involves division of the short urethra and the design of an island flap using penile skin formed into a tube over a sound. Congenital rectourethral fistula and rectobladder neck. Abstract congenital megalourethra is a rare genital anomaly characterized by dilatation of the penile urethra without evidence of distal obstruction. In rare cases, a congenitally short urethra can be the etiology for ventral curvature16,17. Congenital anomalies of the kidney and urinary tract. Download as ppt, pdf, txt or read online from scribd. Pdf to assess the feasibility of chordee correction by mobilization of urethra with corpus spongiosum, and define the guidelines for management of. A report of two cases congenital short patulous urethra is a rare entity and. The patient, a 1monthold boy, had presented at birth with a swollen penis and inability to void. Epidemiology the prevalence of urinary tract infections varies with age and sex. Such pathology is often associated with high perinatal mortality and varying degrees of perinatal and infant morbidity. This article attempts to give a pictorial overview of the congenital anomalies of the male urethra in children. The malformation is also described and differentiated from penile curvature of cutaneous origin.
At 1 to 14 years postoperative followup mean 6 years, all the patients reported no residual curvature on spontaneous erection. Congenital urethral stricture may manifest similarly to urethral valves and may be diagnosed by prenatal ultrasonography, or postnatally by symptoms and signs of outlet obstruction or patent. Urethral duplication with the presence of diverticulum is a rare combination and to the best of our knowledge has not been previously reported. The kidney is the most common site of congenital abnormalities. The urogenital sinus is the precursor of the bladder and posterior urethra. Urethral stricture causes obstruction along some part of the length of the urethra. Urethral injuries in girls are rare because of the short mobile urethra and the wellprotected localization behind the. A case of congenital anterior urethral diverticulum is presented.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. The following case report illustrates the clinical and radiographic findings in a female infant with a. For each of the copum posterior urethra and cobbs bulbar urethra lesions, the degree of obstruction can be variable, consistent with a variable expression of the embryopathy. Ytype congenital urethral duplication with normal dorsal urethra. Patients and methods three boys with a congenital bulbar urethral narrowing cobbs collar were examined. Duplication of urethra is a very rare condition where there is an extra urethra, instead of the normal one. Functionally, the urogenital system can be divided into two entirely different components. Congenital anomalies of urinary system affect 10% of general population, and present. Congenital anterior urethral diverticulum in the male radiology. A posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. Nov 30, 2016 the kidney is the most common site of congenital abnormalities. Pages in category congenital disorders of urinary system the following 26.
Rectourethral fistula and rectobladder neck fistula conditions are found exclusively in male patients. Penile hypospadias with meatal stenosis in a 10yearold male presenting with a short phallus and thin urinary stream. These anomalies can be isolated or in association with other coexisting anomalies. View the article pdf and any associated supplements and figures for a period of 48 hours. Between weeks four and five of fetal life, the cloaca is separated from the amniotic cavity by the cloacal membrane. Congenital anomalies free download as powerpoint presentation. Patients with urethral obstruction do not survive 17. Ppt congenital fetal anomalies powerpoint presentation. A case report tunc ozdemir, akin karagozoglu, ali sayan, gokhan koyluoglu abstract urethral fistulous opening to the penile shaft with or without chordee is extremely rare. Penis and urethra and prostate congenital anomalies. Other chapters consider the pathology of the various congenital malformations of the urethra and penis. Although cakuts are a part of many known syndromes, only few singlecandidate causative genes have been implicated so far in. Considerations are made about embryogenic, diagnostic, clinical picture and treatment.
An overview of the literature on congenital lower urinary. The penile urethra is also dilated distally at the glans penis, where it forms the fossa navicularis. Pathology associations prune belly syndrome 5 bladder agenesis 2 radiographic. Of the congenital anomalies of the urogenital tract, many involve the male urethra table 1, sometimes with associated anomalies of the external genitalia or anorectal malformations. The membranous urethra is the shortest, least distensible portion of the urethra. Urethral agenesis or urethral atresia refers to a situation where there is a congenital absence of the urethra. Congenital anomalies of the male urethra radiology. Recently, a large series of congenital chordee without. Here, a 4yearold boy with congenital urethral fistula is reported. Congenital anomalies of the male urethra pdf paperity. Congenital urethral stricture congenit stricture of urethra.
Renal agenesis and severe renal dysplasia are also termed hereditary renal. Cystourethrography revealed a large septated anterior urethral diverticulum which was subsequently resected. Congenital genito urinary disorders linkedin slideshare. The urethra opens on the dorsum of the glans or penile shaft, or at the penopubic junction. But in our experience congenital urethral stenosis is an important cause of recurrent urinary tract infections. Development and congenital anomalies of urogenital system moderator. Great ormond street hospital for children nhs foundation trust, london, uk.
Renal malformations are often associated with other congenital defects. Development and congenital anomalies of urogenital system. Some cause no problems but many result in impaired renal function. Congenital short penis has been described in bulls and may be associated with short retractor penis muscles, which prevent full erection. Unlimited viewing of the articlechapter pdf and any associated supplements and figures. It is not considered a rare disease, and we must note the existence of such anomaly, especially in boys suffering from recurrent urinary tract infections, dysuria, disturbed voiding, drug resistant diurnal enuresis, pollakisuria or hematuria in pediatric link. The embryologic basis of each anomaly, when known, is discussed. Seven cases of anterior urethral stricture were studied. A markedly dilated urethra is seen proximal to a congenital stricture in the bulbous.
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