Congenital Atresia of Penile Urethra, With Inferior Vesicle Fissure: A Case report

Dr. Divya Tomar (corresponding author), Prof. Rajesh Gupta, Dr. Kanika Bora, Dr. Shubham Tiwari

Sarojini Naidu Medical College, Mantola, Agra, Uttar Pradesh, India 282003

Abstract

Urethral atresia is an uncommon congenital anomaly frequently associated with other genitourinary defects, including bladder exstrophy. We report a rare case of a 4-year-old male presented with continuous urinary dribbling from a midline suprapubic cleft and absence of a urethral meatus. The child also had a history of low anorectal malformation, which was corrected at birth by Anoplasty. The patient was diagnosed as a case urethral atresia with inferior vesical fissure and normal upper urinary tract anatomy after appropriate imaging. The patient was managed with a perineal urethrostomy and primary bladder closure, to establish a functional urinary outlet by bypassing the atretic distal urethra. Postoperative recovery was uneventful, with only a minor wound fistula that resolved spontaneously. The patient was discharged with plans for future staged urethral reconstruction. This case underscores the importance of individualized management and a multidisciplinary approach in treating complex urogenital anomalies. Early intervention can improve functional outcomes and quality of life in children in such cases.