Editing External Genital Anomalies in Boys (section)

=== Accessory Urethral Openings ===
* '''Congenital Urethral Fistula'''
* '''Urethral Duplication'''
** '''Duplication most commonly occurs in the sagittal plane with one urethra located ventrally and the other dorsally'''
*** '''Usually the dorsal urethra is considered the accessory urethra''' with or without a urinary stream, '''whereas the ventral urethra carries the urine stream and the anatomic landmarks such as the external sphincter and verumontanum'''.
** Associated genitourinary, gastrointestinal, and musculoskeletal anomalies may be present
*** Vesicoureteral reflux is the most common associated anomaly
*** Other anomalies include renal agenesis, bilateral cryptorchidism, sacral agenesis, imperforate anus, radial hypoplasia, tracheoesophageal fistula, and other midline defects such as duplicated bladder, duplicated colon, imperforate anus and anorectal agenesis, bifid glans, thoracic hemivertebrae, and partial sacral agenesis
** The most common presentation of urethral duplication is a double meatus and double urinary stream
** Evaluation should include a voiding cystourethrogram, retrograde urethrogram, and direct visualization of the anatomy during cystourethroscopy