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Congenital megalourethra in monochorionic twins: a case report.

Introduction Significant penile urethra dilatation (megalourethra) in neonates has frequently been described in association with other anomalies, and is considered to be part of a more diffuse mesodermal abnormality. Subsequent to documentation of the first antenatally diagnosed case (Benacerraf et al., 1989), prenatally detected megalourethra has rarely been seen in isolation (Jones et al., 2002). Frequently associated anomalies include prune belly syndrome (PBS) (Fisk et al., 1990), VACTERL association (Krapp et al., 2002), and imperforate anus (Wu et al., 1995), among others. Congenital megalourethra is generally associated with poor neonatal outcomes, highlighting the importance of prenatal detection (Sepulveda et al., 2005; Amsalem et al., 2011). Megalourethra is generally not regarded as a genetic disorder. It has only been described once before in a monozygotic twin pregnancy, where the twins were discordant for the anomaly (Pollock, 1965). This report describes a case in which both fetuses of a monochorionic twin pregnancy present with megalourethra and anal imperforation.