Radiographic findings in this condition include a dominant channel that exits onto the perineum.2,3 Management is difficult, as the dorsal urethra is hypoplastic and resection of the ventral urethra can have devastating effects.2,4 Surgical correction is most commonly performed by a 2-part, staged hypospadia correction procedure.2,5 Congenital urethroperineal fistula is manifested by a normal penile urethra with a second ventral channel arising from the prostatic urethra and opening onto the perineum (Figure 3). In patients with a congenital urethroperineal fistula, surgical resection of the ventral channel is the treatment of choice and usually results in a good outcome in the small number of patients reported.2,5 CONCLUSION While both are rare entities, differentiation of the hypospadiac form of urethral duplication and congenital urethroperineal fistula is critical for treatment planning.
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