Urogynecology Community
Female urethral duplication?
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WELCOME TO THE UROGYNECOLOGY COMMUNITY for WOMEN: This Patient-To-Patient Community is for discussions relating to Female Incontinence and Pelvic Floor disorders such as, Cystocele, Drooping Bladder, Intercourse Pain, Pelvic Organ Prolapse, Vaginal Relaxation and Vulvodynia.

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Female urethral duplication?

I'm not sure how to approach this subject.

Recently, I've discovered that my urine has not been exiting my body through my urethra-- or rather, the urethra that I was born with. I've done some research on this, and have found a case that I believe is very similar to my own:

"We present the case of a 34-year-old woman who presented with a stone fragment stuck near her distal urethra without obstruction of her urinary flow. During an attempt to explore and remove the fragment, she was discovered to have complete urethral duplication with the stone stuck in one of two distal urethral orifices. This represents an extremely rare variant of a very unusual congenital anomaly, even more so as it occurs usually in male patients. Embryology, etiology, and clinical appearance of this rare anomaly are discussed."
Copyright © 2007 S. Karger AG, Basel
[ http://content.karger.com/ProdukteDB/produkte.asp?Doi=96943 ]

The reason that I believe that this case is similar to my own is because I specifically remember a time when I was either 9 or 10 that I was having trouble urinating. A few months or so later, I learned what the word "constipation" meant. I believe that once, I described the feeling to my mother as "constipation, but with number 1 instead of number 2." The problem resolved itself, and I didn't think of it again for a few months. At some point, months later, I realized that I could control my urination in a different way than I had before. I also noticed that urination was significantly easier. At 10, I just figured that whatever might have been blocking my urethra had been cleared away. Now, about 2 months ago, I noticed a second hole located near the top of my vaginal opening. Again, I didn't think much of it. Within the last few days, I've realized that I haven't been urinating out of my original urethra at all. This is where I found another case that seemed to be somewhat similar to my own:

"Urethral duplication is a rare finding in females, with fewer than 40 cases published since 1970. We report a case of urethral duplication in a woman with uterovaginal and rectal prolapse but without other associated congenital anomalies. On urodynamic and cystoscopic evaluation, an accessory urethra was noted to emerge from beneath the clitoral hood. The patient underwent exploratory laparotomy and transabdominal excision of the rudimentary urethral orifice with concurrent transvaginal prolapse repair and rectopexy. At 5-year follow-up, the patient continued to be continent and without prolapse."
[ http://www.springerlink.com/content/j0020222gx488078/ ]

I haven't had any rectal problems, but my "second" urethra seems to be located from underneath the clitoral hood as well. Both of the cases above were seen in women in their early 30's-- I am still considered a teen. It doesn't bother me physically, or mentally-- I just want clarification. I want to make sure that there aren't any life-threatening risks or anything. I figure that when I'm older I'll have it corrected, but as of now, it doesn't interfere with my everyday life. Some of the women with this condition reported urinary leakage-- which I did once have a VERY MINOR problem with. After researching urinary leakage years ago, I stumbled upon Kegel exercises, which eliminated the problem altogether.

I guess what I am really looking for here is more information.

Thanks!
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134578_tn?1404951303
Do you think it could be that your urethra is not double but instead came close to the vagina, and the pressure on the original exit caused a rupture a little further up, that made a passage through the vagina?  Do you notice that a tampon gets urine on it?

I'd get a consultation with a specialist.  My ob-gyn is our hospital system's expert in gynecologic urology, or otherwise I would have never heard this is even a specialty.  In your case, I'd try to dig up one of those doctors and have an exam.  If you really do have a double urethra and one voids through your vaginal opening, it seems like a question would be whether or not it could increase the bacteria in the vagina.  Yet urine is said to be sterile, or nearly so.

If you do learn that you have a double urethra or some kind of urethral opening in the vagina, and decide it is something you want to have attended to surgically, be sure they fix the original stone or whatever had blocked the urethra in the first place, and have it working for a few months, before they do anything to shut off the second opening.  The last thing you want to have happen is for them to repair the original block but have the (whatever caused it) continue to be a problem or recur.  At least now you can pee through the backup exit.  (If that is what is really going on.)

An exam from a specialist will tell you a whole lot.  I'd do it.
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134578_tn?1404951303
Do you think it could be that your urethra is not double but instead came close to the vagina, and the pressure on the original exit caused a rupture a little further up, that made a passage through the vagina?  Do you notice that a tampon gets urine on it?

I'd get a consultation with a specialist.  My ob-gyn is our hospital system's expert in gynecologic urology, or otherwise I would have never heard this is even a specialty.  In your case, I'd try to dig up one of those doctors and have an exam.  If you really do have a double urethra and one voids through your vaginal opening, it seems like a question would be whether or not it could increase the bacteria in the vagina.  Yet urine is said to be sterile, or nearly so.

If you do learn that you have a double urethra or some kind of urethral opening in the vagina, and decide it is something you want to have attended to surgically, be sure they fix the original stone or whatever had blocked the urethra in the first place, and have it working for a few months, before they do anything to shut off the second opening.  The last thing you want to have happen is for them to repair the original block but have the (whatever caused it) continue to be a problem or recur.  At least now you can pee through the backup exit.  (If that is what is really going on.)

An exam from a specialist will tell you a whole lot.  I'd do it.
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Avatar_m_tn
madam (indecisive),
my daughter too has same problem .. how have you got it treated?
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Avatar_f_tn
Hi Indesicive.

I have heard of urine coming from the Vagina due to a hole/prolapse from the bladder/urethra into the Vagina.  I feel it would be a good idea to have this looked at by a Urogynecologist as they deal with this type of problem.  At least then you can be assessed and be sure of what is causing it and look at the options.

Even if you dont want to persue the options right away you will be then know about why this is happening rather be left wondering what it is.

I hope this helps
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Avatar_f_tn
Sorry naveen007

My answer was for you as well.  

Thank you
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Avatar_f_tn
I am a 34 year old female with urethral duplication.  I found out when I was 21 and it was a long and painful path that started when I was 16.  I always had 2 streams of urine but I didn't know that I was different.  I started having urinating tract infections at 16 - doctors blamed it on hygiene sex and diet.  I have been treated for over 40 UTIs.  So many my body rejects (severe allergic reactions that could kill) sulfa based drugs commonly used to treat bladder and uti infections.  I had X-rays on kidneys, catheters, blood work and finally at 20 X-rays while peeing standing up. (That was most painful and worst since it defies our nature to sit and pee in private).  I finally got to a Gynourologist and he performed an urethral dilation on my secondary (aux) urethra and I was uti free for almost 8 years. I have 2 boys now so there was no complications with childbirth. I have had 3 UTIs in the past 3 years though,  it is my belief that birth control (long term or high dose) constricts the urethra and contributes to the infections. We have also found that I will have blood in my urine without an infection, though still with pain and discomfort.  Haven't figured it out yet. I am sharing so others who may have this don't feel like a freak - though every new Gyno or urologist always gets a bit excited to see a breathing specimen so it seems.  I have found that by sitting differently on the toilet straight vs slouching back gives me different control over my urination.   If you think you have the same plumbing as me, I do suggest in seeing a specialist so they can guide you to a healthier path.  Take care
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Avatar_f_tn
Thank you for your input.  Do you feel that any further dilation would be helpful in maintaining as easy a flow of urine as possible?  
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Avatar_f_tn
"Urethral duplication
I am a 52 yo female who has recently undergone surgery for a colon resection.  The surgeon has advised post op that I have 2 urethra.  As mentioned by a previous blogger, I too have had a lot of bladder infections & UTI's but I was always told they relate to frequency of intercourse.  
I will interrogate my colon surgeon  to get further information on the function, risks & information on this genetic anomaly.  
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Avatar_f_tn
Hi Squealy.  
I am a bit surprised that your Colorectal surgeon has diagnosed you have 2 urethras although of course they may be completely correct.

The observations of your Colorectal surgeon may actually be very helpful though in you moving forwards with their support and evidence to find out fully about your condition and what you are able to do about this.

As you mention, this may be a genetic issue if a correct diagnosis has been made.  However, you may wish to have further investigations done to confirm this diagnosis and consider you options for management of your condition.

I hope very much that your Colon resection is now healed and that you are happy and well.  

Let us know how you get on.
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