PMC4465739_01
It demonstrates glans diphallia with two separate urethras in which larger catheter passed through ventral meatus and smaller catheter passed through dorsal stenotic urethra (a and b).
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Physical examination revealed the presence of the double glans accompanied by second urethral meatus positioned dorsally (Figure 1).
Voiding cystourethrogram reveals bladder duplication in coronal plane (sagittal view) (a). Spinal magnetic resonance imaging demonstrates butterfly vertebrae in L1, L2, and L3 (b). Voiding cystourethrogram shows two urethral meatus originating from main bladder with the dorsal stenotic (black arrow) and patent ventral urethra (white arrow) (coronal view) (c).
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Further evaluation by voiding cystourethrogram (VCUG) showed duplex bladders in the coronal plane (Figure 2(a)). Further study by spinal magnetic resonance imaging revealed butterfly vertebrae in L1, L2, and L3 (Figure 2(b)). Overall, the patient had bladder duplication in the coronal plane with two distinct urethras, both originating from the main bladder, accompanied by glans diphallia with dorsal stenotic urethra (Figure 2(c)).
Intraoperative imaging shows two bladders in coronal plane attached to common septum (a). Two urethral meatus were evidently originating from main bladder (b).
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After opening the main bladder, the septum between the two bladders was resected and the two lumens were anastomosed (Figure 3).