Complete Urethral Duplication With Epispadias in a Young Man: A Case Report

A 25 year male patient presented with the complaints of passage of urine through two openings on his penis, with deformities of penis since birth. After birth his parents noticed, when he micturates, urine comes through an opening on the proximal part of dorsal surface of penis in addition to the opening on the tip of glans penis. The penis is also a bit deformed and dorsal part of corona glandis is bifid. No treatment for the anomaly was taken. At puberty his testes, scrotum and other secondary sexual characteristics developed normally. He feels sexual attractions to opposite sex and experiences nocturnal emissions periodically. His penis erects on sexual stimulations, but bends upwards and at the peak of excitement orgasm also occurs and semen comes through the ventral orthotopic opening only. General physical examination was unremarkable, but external genitalial examination, shows, two external urethral meatus – one small pit like opening at the normal orthotopic position on the tip of glans penis and another on the dorsal surface of proximal penile shaft with epispadias and exposed urethral plate distal to this.. He had also dorsal chordee and ventral hooding with dorsal bifid glans penis. He had normally developed scrotum with normal both testes . Corpora cavernosa are developed but separated proximally. Spongiosa also developed and orthotopic anterior urethra can be palpated. Other systemic examinations revealed no abnormalities. Routine investigations like urine R/E, C/S, S.creatinine, blood sugar, CBC were normal. X-ray KUB revealed small separation of pubic symphysiis. USG of whole abdomen with KUB revealed significant PVR (77cc) with features of cystitis (sediments in bladder) with no other abnormality. RGU and MCU revealed duplicated urethra –with an accessory urethra arising from bladder neck, runs above the orthotopic one along the shaft terminating at the proximal part of dorsal penile shaft. The lower orthotopic urethra is normal with no stricture or abnormality except narrowing of the distal anterior urethra and external opening. Cystogram shows normal bladder with no VUR or divarticula except thickend wall. Urethrocystopic examination after dilatation of stenosed EUM of orthotopic (ventral) urethra showed normal anterior and posterior urethra containing sphincter and verumotanum and prostatic urethra opening into the bladder neck. Then cystoscope passed through the dorsal epispadiac urethra , which showed a less developed urethra, opening into the protruding bladder neck. Urinary bladder and ureteric orifices were normal . Then excision of accessory epispadiac urethra and the urethral plate done as high as possible near to bladder neck, followed by correction of chordee by ventral plication and repair of bifid corona glandis. He had an uneventful recovery ,though having a residual dorsal chordee, which was corrected by a second operation after 18 months, when excision of residual stump of accessory dorsal urethra followed by dermal graft repair of dorsal corporal body done. Bangladesh Journal of Urology, Vol. 21, No. 1, January 2018 p.48-51

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Dorsal Surface of the Tongue of the Hazel Dormouse Muscardinus Avellanarius: Scanning Electron and Light Microscopic Studies/ Grzbietowa Powierzchnia Języka Orzesznicy Muscardinus Avellanarius: Badania Z Wykorzystaniem Mikroskopu Skaningowego I Świetlnego

Zoologica Poloniae ◽

10.2478/zoop-2014-0004 ◽

2014 ◽

Vol 59 (1-4) ◽

pp. 35-47 ◽

Cited By ~ 5

Author(s):

Katarzyna Wołczuk

Keyword(s):

Feeding Habits ◽

Dorsal Surface ◽

Proximal Part ◽

Middle Part ◽

Taste Buds ◽

Microscopic Studies ◽

Filiform Papillae ◽

Hazel Dormouse ◽

Muscardinus Avellanarius ◽

Scanning Electron

Abstract The dorsal surface of a hazel dormouse tongue was examined by scanning electron and light microscopy. The tongue of the hazel dormouse is elongated and widened in the proximal part. On the proximal one-third of the tongue a clear median groove is observed. The dorsal lingual surface was covered with five types of papillae: filiform, conical, fungiform, vallate and foliate. The arrangement, shape, size and direction of the filiform papillae vary depending on the region of the tongue. On the proximal part of the tongue, the filiform papillae are saw-like and tilted medioposteriorly, while on the distal part they have a fork-like shape and form a radial pattern with their processes oriented towards the center of the tongue. Fungiform papillae with single taste buds are evenly scattered on the anterior and middle part of the tongue body. On the root of the tongue, three star-like shaped vallate papillae are arranged in the form of a triangle and surrounded by conical papillae. A pair of foliate papillae are found on both edges of the posterior area of the tongue, forming three parallel folds separated by deep grooves. The dorsal surfaces of the vallate and foliate papillae are covered with hard-cornified epithelium, while the lateral surfaces have noncornified epithelium with numerous taste buds. The results of our studies show that the tongue structure of the hazel dormouse is more primitive in comparison with other rodents which is related to their phylogeny and feeding habits.

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Management of Gunshot Injury of Glans Penis that Extends to Anterior Urethra: A Rare Case Report

Medical Bulletin of Haseki ◽

10.4274/haseki.3125 ◽

2016 ◽

Vol 54 (4) ◽

pp. 249-251

Author(s):

Özkan Onuk ◽

Burak Arslan ◽

Fatih Yanaral ◽

Aydın İsmet Hazar ◽

Arif Özkan ◽

...

Keyword(s):

Case Report ◽

Rare Case ◽

Gunshot Injury ◽

Glans Penis ◽

Anterior Urethra ◽

Rare Case Report

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Congenital Megalourethra Associated With Urethral Duplication: A Case Report

Bangladesh Journal of Urology ◽

10.3329/bju.v19i1.49351 ◽

2020 ◽

Vol 19 (1) ◽

pp. 53-56

Author(s):

Muhammad Humayun Kabir ◽

Tanvir Ahmed ◽

Md Saiful Islam ◽

SM Yunus Ali ◽

Md Rafiqul Islam

Keyword(s):

Seminal Fluid ◽

External Sphincter ◽

Voiding Cystourethrogram ◽

Corpus Spongiosum ◽

Urethral Meatus ◽

Anterior Urethra ◽

Secondary Sexual Characteristics ◽

Normal Bladder ◽

Sexual Characteristics ◽

Secondary Sexual

A 28 years old male with well developed secondary sexual characteristics was admitted in BSMMU with a grossly swollen, malformed phallus and passage of urine mostly through an opening in the perineum. After birth, his parents noticed that when the baby micturates the phallus is swollen and few drops of urine comes out through the external urethral meatus but most of the urine comes out through an opening in the perineum. No treatment was taken by his parents for this complaint. At puberty his secondary sexual characteristics developed normally. He felt sexual urge towards females but his penis was not erected. At the peak of his sexual excitement, orgasm occurs with release of whitish seminal fluid which comes mostly through perineal opening. His general physical examination was unremarkable & examination of the genitalia revealed well developed scrotum. Both of the testes were normal in size, shape and consistency but the penile shaft was large and flabby, and the ventral aspect of the penis appeared as a sac with mild pseudo phimosis. Careful palpation suggested the absence of the corpus spongiosum & corpora cavernosa. Both these findings were subsequently confirmed by a duplex colour doppler study. The penis distended ventrally when he tried to micturate and the urinary stream was narrow. About 75% of urine flow evacuates through perineal opening which was located about 2 cm from anal opening in the midline ventrally. A voiding cystourethrogram revealed that whole of the anterior urethra was grossly dilated with narrowing at the bulbar part & external urerthral meatus. There was another passage (about 5 cm) from the scrotal margin up to proximal posterior urethra. Cystogram showed a bladder diverticulum at left lateral wall. An urethrocystoscopic examination revealed that just proximal to the stenosed external urethral meatus the urethra is widely dilated which seemed like a transparent fusiform sac with irrigating fluid. Whole of the anterior urethra was very thin walled with transmitting lights through it. Proximal part of the urethra near the external sphincter was grossly narrowed. Urethrocystoscope was also introduced through the abnormal urethral opening into the perineum which was located in the midline raphe of the perineal region about 2 cm from the anal verge. This urethra joined with the penile urethra distal to the external sphincter. Prostatic part of the common urethral channel was normal containing verrumontanum and a normal bladder neck. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.53-56

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Structure of the compensation sac in two ascophoran bryozoans

Proceedings of the Royal Society of London Series B Biological Sciences ◽

10.1098/rspb.1970.0021 ◽

1970 ◽

Vol 175 (1040) ◽

pp. 235-254 ◽

Cited By ~ 13

Keyword(s):

Cell Proliferation ◽

Growth Model ◽

Dorsal Surface ◽

Proximal Part ◽

Ventral Surface ◽

Body Cavity ◽

Structural Differences ◽

Frontal Wall ◽

Epithelial Fusion

Harmer established two groups of ascophoran bryozoans on structural differences in the compensation sac (ascus) and the frontal wall, although both he and Silén believed that the frontal wall of both groups is deposited within a simple ventral fold of ‘frontal membrane’. Such a fold would be expected to secrete a wall consisting of mineral and/or organic successions disposed symmetrically on either side of the first-formed layer. A study of Schizoporella and Umbonula , typifying the two ascophoran groups, showed asymmetrical frontal walls and other deviations from the Harmer–Silén growth model. In both genera, ascus development is determined by the formation and rapid migration of generative zones which result from the fusion of epithelia secreting periostracum and carbonate respectively. Differences in the location and timing of these processes influence subsequent events. In Schizoporella , the first-formed layer of the frontal wall is secreted within an epithelial fold which is separated from the overlying ventral periostracum and associated epithelium by an extra-zooecial body cavity. Next follows a fusion of the carbonate- and periostracum-secreting epithelia just proximal to the orifice, and the migration of the more proximal part of the junction to the zooecial walls. Cell proliferation in the wake of this retreat leads to the formation of the ascus floor. Exposed primary calcite on the dorsal surface of the frontal wall constitutes the roof of the ascus and, contrary to the Harmer–Silén model, shows no trace of periostracum or associated epithelium. In Umbonula , epithelial fusion occurs just within the periphery of the ventral surface, and the roof of the ascus is secreted by cells of a generative zone as it advances towards a submedial position near the orifice. The roof consists of a thin but complete periostracum continuous with that forming both the floor of the ascus and the ventral cover of the zooid. The calcareous frontal wall is subsequently deposited on the roof periostracum by the dorsal or carbonate-secreting layer of the doubled epithelium.

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Comparison of Bracka I versus Blair-Byar’s technique in chordee correction.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.07.4168 ◽

2020 ◽

Vol 27 (07) ◽

pp. 1420-1423

Author(s):

Masood Mahmood ◽

Imran Qadir ◽

Sadaqat Ali ◽

Muhammad Sarfraz Khan

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Foley Catheter ◽

Sampling Technique ◽

Uneventful Recovery ◽

Procedure Time ◽

Urethral Plate ◽

Second Stage ◽

Flap Technique ◽

Urinary Stream

To compare the outcome of the Bracka I Graft Technique versus Blair-Byar’s Flap technique in orthoplasty for urethral plate in terms of procedure time, hospital stay and urine stream after removal of Foley catheter. Objectives: There are multiple types of procedures to correct the chordee in hypospadias with chordee cases. We planned to perform study to discuss the differences between Bracka I where Graft is used for the plate of urethra and Blair-Byar’s flap technique in term of procedure time hospital stay and urine stream after removal of Foley catheter. Study Design: Randomized Control Trial study. Setting: Pediatric Urology Department, Children Hospital Faisalabad (CHF). Period: 1 year and 9 months, from April 2016 to December 2018. Material & Methods: Total 80 patients were taken with Non probability consecutive sampling technique was adopted with inclusion criteria with more than 2 years of age and hypospadias with chordee while, exclusion criteria of patients were previous surgery of chordee correction and any other associated anomalies. Results: In the patients with Bracka I procedure, n=37 patients (92.5%) have uneventful uptake of graft, where two (5%) patients have failure of uptake of graft while one (2.5%) of them had wound infection and adequate urinary stream after removal of Foley was found in all 40 patients. In Blair-Byar’s technique procedure had uneventful uptake of graft in n= 36 patients (90%) where two (5%) patients have failure of uptake of graft while two (5%) of them have wound infection. Cosmetically acceptance was in 39 patients (97.5%) by the parents and feasibility to do the second stage. While among Blair-Byar’s technique cosmetically acceptance was in 35 patients (87.5%) by the parents and feasibility to do the second stage. Conclusion: Bracka I (graft) Orthoplasty and Blair-Byar’s (flap) Orthoplasty has equivocal results in terms of tissue uptake and uneventful recovery, urinary stream post operatively, post-operative meatal diameter while cosmetically Bracka 1 is superior to Blair-Byar’s technique while feasibility of the availability of local tissue to make tube for urethroplasty in stage II.

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Organ-Sparing Surgery for a Giant Verrucous Carcinoma of the Penile Shaft: A Case Report and Review of the Literature

Case Reports in Urology ◽

10.1155/2019/1537379 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Prodromos Philippou ◽

Christos Kitsios ◽

Maria Miliatou ◽

Christiana Poullou ◽

Pavlos Konstantinou

Keyword(s):

Squamous Cell Carcinoma ◽

Organ Preservation ◽

Clinical Presentation ◽

Verrucous Carcinoma ◽

Dorsal Surface ◽

Review Of The Literature ◽

Penile Shaft ◽

Rare Lesion ◽

Well Differentiated ◽

Penile Squamous Cell Carcinoma

Verrucous Carcinoma is a rare but well-differentiated variant of penile squamous cell carcinoma. Its clinical presentation is usually that of an exophytic cauliflower-like lesion with a broad-based growth pattern. We herein report the case of a 61-year-old man who presented with a giant verrucous carcinoma occupying the dorsal surface of the penile shaft. The patient underwent penile-sparing surgery, achieving both disease control and organ preservation. We discuss relevant issues, including clinical features, diagnosis, surgical management, and prognosis and we review the rather sparse literature regarding this rare lesion.

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What is normal bladder neck anatomy?

International Urogynecology Journal ◽

10.1007/s00192-015-2916-1 ◽

2015 ◽

Vol 27 (6) ◽

pp. 945-950 ◽

Cited By ~ 18

Author(s):

Cristina Naranjo-Ortiz ◽

Ka Lai Shek ◽

Andrew James Martin ◽

Hans Peter Dietz

Keyword(s):

Bladder Neck ◽

Normal Bladder ◽

Neck Anatomy

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Scanning electron microscopy of the integument of schistosoma rodhaini

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010014230x ◽

1986 ◽

Vol 44 ◽

pp. 132-133

Author(s):

P. Evers ◽

C. Schutte ◽

C. D. Dettman

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Oral Sucker ◽

Adult Male ◽

Dorsal Surface ◽

Ventral Surface ◽

Sensory Receptors ◽

East African ◽

Dorsal Midline ◽

Scanning Electron

S.rodhaini (Brumpt 1931) is a parasite of East African rodents which may possibly hybridize with the human schistosome S. mansoni. The adult male at maturity measures approximately 3mm long and possesses both oral and ventral suckers and a marked gynaecophoric canal. The oral sucker is surrounded by a ring of sensory receptors with a large number of inwardly-pointing spines set into deep sockets occupying the bulk of the ventral surface of the sucker. Numbers of scattered sensory receptors are found on both dorsal and ventral surfaces of the head (Fig. 1) together with two conspicuous rows of receptors situated symmetrically on each side of the midline. One row extends along the dorsal surface of the head midway between the dorsal midline and the lateral margin.

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