Partial duplication of the urethra: the paraurethral duct. Errors in diagnostics and treatment

Duplication of the urethra is a rare abnormality, which forms during embryogenesis from the urethral groove. Up to the date, only about 500 cases of urethral duplication have been described. Its most common form is the formation of the paraurethral duct. This abnormality is not followed by any symptoms and may be revealed only in case of infection by the signs of dysuria, which are similar to the clinical course of acute prostatitis or urethritis. For the diagnostics of the condition, thoroughful history taking, symptom analysis, ureteroscopy and retrograde urethrography should be performed. This study presents a clinical case of a paraurethral duct in a male patient, aged 43, describing the difficulties and errors in the diagnostics. Over the period of three years, the patient has been complaining about pain in the urethra during urination and erection. The urologists examining this patient diagnosed him with acute exacerbation of chronic prostatitis and prescribed a treatment with an insignificant effect. The patient underwent ureteroscopy, retrograde urethrography, which revealed the paraurethral duct. In order to unite the urethral lumen and the paraurethral duct, the patient underwent endoureterotomy. No signs of dysuria and painful erection were observed upon the recovery of urination.