Urethral agenesis and congenital urethral atresia

　　The true cause is unknown, and it may be that during embryonic development, the epithelial tissue of the urethra did not fold back in time inside the urethra, or the development of the urethral epithelium at the glans penis was obstructed; it may also be that the urogenital sinus membrane failed to perforate, forming a membranous atresia. The disease is more common in males than in females. It may also be related to environmental factors during pregnancy, whether to take prohibited drugs, whether the diet is balanced, and psychological state.

　　Proximal to the valve, the prostatic urethra in male infants dilates, the bladder neck gradually thickens, the bladder wall thickens and expands, trabeculae elongate, and pseudodiverticula form. Most cases have varying degrees of upper urinary tract dilation and vesicoureteral reflux, which are prone to secondary infection on the basis of obstruction and reflux, further aggravating renal damage. There may also be associated renal developmental abnormalities. The valve is usually located on the ventral side of the urethra near the penoscrotal junction,呈尖瓣、虹膜瓣或半月形, causing lower urinary tract obstruction. In severe cases, it can lead to secondary upper urinary tract dilation and hydrops, symptoms of lower urinary tract obstruction, difficulty in urination, thin and weak urinary stream or dripping, acute urinary retention, swelling of the penile root during or after urination, bloodstains on underwear, and growth retardation.

　　Due to urethral atresia, fetal urine accumulates during embryonic development, causing bladder distension, compression of the umbilical blood vessels, or renal pelvis hydrops due to urethral obstruction, leading to renal atrophy. The kidneys may have already died during embryonic or birth stages. Survivors usually have an excretory path for fetal urine, such as an open umbilical urachus, residual cloaca, bladder-rectum or vagina fistula, urethra-rectum or vagina fistula, etc. Some may survive at birth but die soon afterwards.

　　The etiology of the disease is not clear. It may be that the epithelial tissue of the urethra does not fold in time during embryogenesis, or the development of the urethral epithelium at the tip of the penis is obstructed; or the urogenital sinus membrane may not be pierced, resulting in membranous atresia. Therefore, it is impossible to prevent it. Early discovery, early diagnosis, and early treatment are of great significance for the indirect prevention of the disease. Regular checks should be done during pregnancy. If there is a tendency of developmental abnormalities in the child, chromosomal screening should be done in time, and artificial abortion should be performed promptly to avoid the birth of children with the disease.

　　1. The main observation for the examination of congenital urethral atresia and absent urethra is the urinary voiding status after the baby is born. If there is no urination, it should be catheterized or examined with a urethral probe.

　　2. If the insertion of a catheter or urethral probe is obstructed, further urethrogram or cystogram after suprapubic bladder puncture should be performed to observe the path of urine excretion and whether there are other malformations.

　　1. Foods that are good for the body for absent urethra and congenital urethral atresia

　　It is advisable to eat light and nutritious food, eat more vegetables and fruits such as bananas, strawberries, apples, etc. Because they are rich in nutrients, eat more foods that enhance immunity such as propolis. To enhance personal resistance to diseases. In addition, a reasonable diet should be maintained and attention should be paid to adequate nutrition.

　　2. Foods to avoid for absent urethra and congenital urethral atresia

　　Avoid smoking and drinking, avoid spicy and greasy foods, avoid cold and raw foods. To avoid the recurrence of diseases.

　　1. Treatment

　　Once the disease is found, it should be treated immediately. For those with absent urethra, immediate suprapubic cystostomy should be performed. For those with renal failure, bilateral nephrostomy should be performed. For those with urinary extravasation, urinary extravasation drainage should be performed, and antibiotics should be added. After the renal function improves and the child grows up, urethral plastic surgery and malformation correction surgery should be performed. If it is a membranous atresia, the diaphragm can be pierced with a urethral probe, and a catheter should be left in place.

　　2. Prognosis

　　The prognosis of urethral atresia depends on the location of the atresia. If it is a posterior urethral atresia, it is the same as the absence of the urethra, and most of them die soon after birth or soon after birth.