Congenital anterior urethrocutaneous fistula at penoscrotal junction with proximal megalourethra
A two-year-ten-month-old boy presented with a fistula located at penoscrotal junction. His parents just noticed it recently before bringing him to a doctor. There was no history of trauma or surgical intervention. The physical examination of the patient showed a tiny hole at penoscrotal junction with urine leakage. The preputial skin was intact with a normally placed external urethral orifice and absent chordee. Voiding cystourethrography with a 3.5 Fr urethral catheter inserted smoothly through external urethral orifice showed a jet of urine through the fistula at penoscrotal junction with proximal saccular dilated penile urethra (Fig. 1). The urine was passing mostly through the fistula but also from the external urethral orifice which might be related to the catheter in the distal urethra at micturition. The patient was referred to the specialist for operation. Congenital anterior urethrocutaneous fistula is a rare anomaly with only 47 cases in the literature, 3 at penoscrotal junction, and 1 with proximal megalourethra.