Congenital urethroperineal fistula.

PURPOSE: To characterize the radiographic appearances of congenital urethroperineal fistula and to distinguish it from urethral duplication of the hypospadiac type.

MATERIALS AND METHODS: The authors examined four patients with congenital urethroperineal fistula in whom radiographic examinations were performed to define the pathologic anatomy.

RESULTS: Congenital urethroperineal fistula mimics the hypospadiac form of urethral duplication, except the normally positioned dorsal channel is the normal urethra. Patients with congenital urethroperineal fistula have normal micturition. Both a normal dorsal penile urethra and a ventral urethroperineal fistula can be observed during radiographic and cystoscopic examination. The dorsal urethra is the functionally normal channel. Excision of the ventral channel is simple and curative. This contrasts starkly with congenital urethral duplication of the hypospadiac type, where excision of the ventral channel may be catastrophic.

CONCLUSION: Although it resembles the hypospadiac form of urethral duplication, congenital urethroperineal fistula should be classified as a separate entity.