Urethra duplication with bladder outlet membrane obstruction

A two-year-old boy presented with voiding through two orifices, with one greater than the other. On physical examination, he had bifid glans penis with a complete foreskin and no other anomaly (Figure 1). The urinalysis and urine culture were normal. It is difficult to find the internal opening of the urethra by cystoscopy through cystostomy. Catheterization through the external openings of the urethras revealed parallel incomplete urethral duplication superimposed with common prostatic urethra (Figure 2). After retreating of the catheter, it was found that in the internal opening of the urethra there was a valve-like membrane. Following removal of the membrane by a holmium laser, one coarse and one small flows were seen. The patient was discharged uneventfully two weeks later. Discussion