Fig. 2 Fluid collection (white arrows) in the retropubic space of Retzius with restriction of diffusion, relation, and edema with urethral duplication.
Laboratory analysis revealed WBC-13500/C.mm, Platelets-214000/C.mm, Neutrophil-86%, Lymphocyte-13%, pus culture and sensitivity- no growth, Hb-16.4%, blood culture was sterile. Urine analysis showed trace proteins with 2 epithelial cells/hpf. The patient was planned for complete excision of the accessory urethra from the normal urethra with drainage of collection. Before surgery, a cystourethroscopy was performed that showed a normal urethra, a normal intact external urethral sphincter, and a normal prostatic urethra; the bladder neck, and bladder were observed and were also normal. This was followed by exploration and drainage of 20 ml pus. The skin was completely degloved, and the accessory urethra was excised down as deep as possible behind the symphysis pubis. Then, an excision of a 10 cm long urethral tract extending up to the retropubic space was done (Fig. 3 a,b,c).