A 4-year-old male child is brought to the pediatric clinic by his parents, who are concerned about his urination pattern. They have noticed that he is frequently wetting his clothes during the day, despite being toilet-trained for the past year. Additionally, he often has a double stream of urine, with one stream coming from the usual location at the tip of the penis and the other from a second, smaller opening located on the shaft.

Upon examination, the child appears healthy, but the pediatrician notices the presence of two distinct urethral openings, one at the tip of the penis and another along the shaft. A urinary tract ultrasound is ordered to further evaluate the anomaly, which shows the presence of a duplicated urethra. The duplicate urethra does not appear to be associated with any significant obstructive symptoms, but it is contributing to the child’s incontinence.

The diagnosis of urethral duplication is made, a rare congenital condition where two urethras develop, resulting in multiple urethral openings. In this case, the child’s condition does not seem to be causing severe urinary tract infections or obstruction, but the double stream of urine is affecting his daily life.

The pediatric urologist discusses treatment options with the family. In this case, observation may be appropriate since the condition is not causing significant functional issues. However, surgery may be considered if incontinence persists or becomes more problematic. The family is reassured that, with careful management, the child can lead a normal life. A follow-up plan is established to monitor for any changes or complications.