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

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.