Congenital Urethroperineal Perineal Fistula (CUPF): Endoscopic Evaluation and Perineal Approach Excision
Yaser El-Hout, MD, Rashed Ghandour, MD, Jad Degheili, MD, Laura Whittaker, BSN, Ahmad Zaghal, MD, Samer Doughan, MD.
American University of Beirut Medical Center, Beirut, Lebanon.
Background: CUPF is a rare congenital urethral duplication anomaly reported around 25 times in the literature. According to Effmann Classification , it is a Type II, 2A-Y duplication. We describe the clinical presentation, imaging, endoscopic evaluation and surgical management in a child with CUPF. Methods: A 4 year old toilet trained boy presented with perineal wetting whilst voiding, but dry between voids. He had recurrent febrile UTIs. VCUG and cystoscopy revealed a 5 cm duplicated urethral tract arising in the right lateral wall of prostatic urethra and draining in the right posterolateral anal verge. Transaction and suture ligation of the tract was performed through a perineal approach. Results: The procedure time was 130 minutes with minimal blood loss. Foley catheter was removed in postoperative day 10. In one year follow-up, the patient is completely dry and is infection-free. Conclusion: This video demonstrates the presentation and management of CUPF, a rare anomaly in pediatric urology.
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