Background: H-type urethral duplication is the most complex form of th
is uncommon anomaly. Methods: This report describes the treatment of f
our such patients, three of which had hypoplasia of the entire anterio
r urethra, and one had anterior fusiform megalourethra. Results: Satis
factory results were obtained in all four by staged surgical managemen
t in which the anal opening was transposed to the perineum, preserving
the continence mechanism. Subsequently, urethroplasty was performed.
In one patient, the megalourethra was tailored and incorporated into t
he urethroplasty in a third-stage procedure. All patients were well on
follow-up. Conclusion: With early treatment, good results can be achi
eved in this condition. Copyright (C) 1998 by W.B. Saunders Company.