Failed Repair of Y‐Type Urethral Duplication Resulting in Permanent Urinary Diversion: A Case Report

Urethral duplication is a rare congenital anomaly characterized by two urethral channels. It requires precise assessment for accurate diagnosis and is often managed surgically. Without appropriate patient selection or technique, correction may fail, leading to undesired long‐term urinary diversion. An 11‐year‐old boy who had unsuccessful surgical correction of urethral duplication remained dependent on a vesicostomy. Imaging and endoscopy revealed severe proximal urethral obliteration, making reconstruction impossible; permanent urinary diversion via a Mitrofanoff channel was advised. Conservative management should be considered in selected cases, as its advantages can outweigh the potential complications of surgery. In a complex type IIA2 “Y” variant, resection of the ectopic ventral segment, which is often more functional, may not succeed and could necessitate lifelong diversion with considerable psychosocial implications. Compared with vesicostomy, the Mitrofanoff channel provides a more acceptable alternative. To prevent such failure in resource‐limited settings, early referral to specialized centres, adherence to modern reconstructive principles, and realistic counseling are crucial.