Megalourethra and urethrorectal fistula: a rare presentation and a challenging reconstruction

Congenital megalourethra is a rare genital anomaly characterized by dilatation of the penile urethra with or without evidence of proximal or distal urethral obstruction. The urethra shows lack of corpus spongiosum and in some cases corpora cavernosa in the region of the distal urethra. The absence of these structures causes a ballooning of the urethra despite no mechanical obstruction. Some authors have also reported cases with prune-belly syndrome–like features (1, 2), so as the presence of urethral duplication (3). We want to present a patient treated in our institution with megalourethra and urethrorectal fistula.