1737Vol. 11    |    No. 03    |     May - June 2014    |U R O LO G Y   J O U R N A L

PICTORIAL

Megalourethra: A Rare Clinical Entity
Pawan Vasudeva, Niraj Kumar, Sanjeev Kumar Jha

Corresponding Author:

Pawan Vasudeva, MD 
Department of Urology, Vardh-
man Mahavir Medical College and 
Safdarjang Hospital, New Delhi 
110029, India.

Tel: 011 2670 7426
Fax: 011 2619 0954
E-mail: drpawanvasudeva@gmail.
com

Received August 2013
Accepted December 2013

Department of Urology, Vardh-

man Mahavir Medical College 

and Safdarjang Hospital, New 

Delhi 110029, India.a

A 7 years old boy presented with history of poor urinary stream, ballooning of penis during micturition and post void dribbling since birth. Physical examination 
revealed an enlarged penis with redundant skin on the ventral 
surface (Figure 1). Both corpora cavernosa were normal. Ul-
trasound of kidney, ureter and bladder demonstrated bilateral 
normal kidneys with negligible post void residual urine. Com-
puterized tomographic (CT) voiding cystourethrogram demon-
strated marked dilatation of penile urethra along with left side 
grade I vesicoureteral reflux (VUR) (Figure 2). A diagnosis of 
scaphoid megalourethra was made and the patient underwent 
reduction urethroplasty (Figure 3). At one year follow up, the 
patient is asymptomatic and the left VUR has resolved. 
Megalourethra, a rare congenital anomaly of the urethra, is 
characterized by a deficient corpus spongiosum with and 
without a deficient corpora cavernosum, leading to anterior 
urethral dilatation. Two varieties are recognized: scaphoid, 
in which corpus spongiosum alone is deficient and fusiform, 
in which both corpus spongiosum and corpus cavernosum 
are deficient.(1,2)  Though the scaphoid variety is more com-
monly seen, it is the fusiform variety which is commonly as-
sociated with other congenital anomalies and hence carries a 
poorer prognosis.(2,3)

REFERENCES

1. Kajbafzadeh A. Congenital urethral anomalies in boys. Part II. Urol J. 2005;2:125-31.

2. Khan RA, Wahab S, Ullah E. Clinics in diagnostic imaging (130). Congenital megalourethra. Singapore Med 
J. 2010;51:352-5.

3. Sharma AK, Shekhawat NS, Agarwal R, Upadhyay A, Mendoza WX, Harjai MM. Megalourethra: a report of 
four cases and review of the literature. Pediatr Surg Int. 1997;12:458-60. 

Figure 1. Penile appearance at presentation.

Figure 3. Reduction urethroplasty: A, degloved penis showing mega-
lourethra; B, urethra opened ventrally; C, urethra tapered; D, urethral 
repair over catheter.

Figure 2. Computed tomography voiding cystourethrogram: left, two 
dimensional reformatted image demonstrating megalourethra; right, 
three dimensional reformatted image demonstrating megalourethra and 
left vesicoureteral reflux.