Double Urethras

[Guest Evan_J]

Up until today, I thought was "common" that female bodied people could either have one or two urethra openings. By a wierd set of events, I needed to look up why that sometimes occurs. In trying to do so I found VERY little information. Most all of the information referred to males and the instances google turned up the circumstance for female bodied people it mostly said "very rare circumstance" , "very odd circumstance" and such in urology journals that could only be read in their entirety by medical professionals . Pretty much all of those also talked about intersexing, phallic urethras and the fact that several of the female bodied peeps with the occurance were also xxy46's. So, realizing this isn't a board filled with urologists, do any of the membership know "what's up with that?" IS it that uncommon? Are there any intersex members with the circumstance? Maybe someone who works for a urologist that knows?

[Guest Jewel]

Interesting... I wasn't aware of that before, but I looked it up in a text I have on vaginal and urological surgery and the only mention indicates that it is "extremely rare" (direct quote).

The abstract from the article here claims

"Urethral duplication is a rare finding in females, with fewer than 40 cases published since 1970."

Also, this page claims that it is quite rare, period, regardless of birth sex, with only about 200 cases total reported in the medical literature.

Sometimes urethral duplication in those natally female is a consequence of an ectopic ureter

It can be associated with virilization and with intersex conditions, but it seems like many of the reported cases are not, for instance here. Wish we could access the full articles...

[Guest Jewel]

Oh... this is a good article if you're willing to wade through the jargon

Most interesting bit here:

"In females, urethral duplication is classified into the following types:

* Double urethra and double bladder

* Double urethra, single bladder

* Accessory urethra posterior to the normal channel

* Double proximal urethra and single distal urethra

* Single proximal urethra and duplicated distal urethra."

and

"Most patients have no symptoms except for, perhaps, a double stream. Other presentations may be incontinence, urinary tract infections and bladder outflow tract obstruction."

[Guest Evan_J]

Thank God for people like Jewel . Ok, so could be an intersex trait, could be not.

[Guest Elizabeth K]

I had a friend who's wife was diagnosed as a twin - four ovaries, two reproductive systems, but only one vagina. She was pregnant two time, twins the first time (unidentical, triplets the third - made medical history - triplets, were two identical, one not. And strangely - ALL girls! After that - she had all the tubes tied. My friend had to get an additional jobs to support them!

This could be a similar thing. Some say may intersexed may be twins that did not develop fully.

No idea on the double utheras, other than that.

Lizzy

[JJ]

What a weird journey I have been on since realizing I was transsexual I have done a lot of reading and just discovered today that not everyone has 2 urethras. Actually I guess it would be more accurate to say I discovered I had another urethra near the vagina-very tiny and not very functional one besides a clitoral one and then discovered having 2 was really different. Kind of odd for some one 63 not to realize before that I was abnormal but I always felt so different and after being molested at 6 was so self protective I just never realized it was abnormal. Whenever I've had a GYN exam with a new Dr. I always get a funny look or reaction but when I've asked I always get -it's nothing to worry about or something along that line. Never an explanation-but it has been disquieting enough that Ivhave avoided exams for years now-even refusing to go back when a Dr insisted. I sort of thought it might be some visible result of being molested they were seeing . I've also had comments about how large my labia are .

It all started this morning when my daughter asked if I might be a chimera. My father was an identical twin and there are several sets of identical twins in my family but I doubted it because of the rarity of the condition. But I have always been a bit of a mix physically. My hair which is light blond has distinct streaks of red and light brown in it. Not mixed in but in streaks. It was so pronounced I colored my hair for almost 50 years. Now that I'm past menopause the red-copper penny red-has turned white, the blond stayed blond but I'm getting black-jet black -hair intermixed. I have unusually broad shoulders and a square jaw and had unusual muscle strength. But a tiny waist-at one point I was 36-21-34 and beautiful. Not pretty or cute though. My features were too strong for cute.

Then today I came across mild Congenital Adrenal Hyperplasia which I believe can cause twin urethra in rare cases. I have so many of the symptoms- I was the tallest kid in my class, eventually in my school till puberty when everyone shot up past me. I haven't grown since I turned 10. There was no acne problem and my body hair texture is so pale and fine it doesn't show so I never thought about it. I had a terrible time from adolescence with dizzy spells and have always had to consume very large amounts of salt or I develop low blood pressure. I've also had glucose tolerance tests-the 8 hours in the Dr's office kind-and have low blood sugar. I am now overweight after being way too underweight till puberty and Drs are always amazed at how low my blood pressure is. Onset of puberty was barely 10. I did not get pregnant during relationships while not on birth control when in my 20s but at 29 got pregnant while married and on low dose birth control. My daughter is not transgender but looks somewhat masculine.

And I have a reaction to cortisone which I was prescribed for lupus. I gained 165 lbs-yeah 165- and it stays in my system far longer than normal. My mother had the same intolerance and was treated for side effects from cortisone for almost 20 years before they subsided. She didn't have the weight gain but other side effects. I can't even use hydro cortisone on my skin. I had a terrible reaction that took quite a bit of treatment to clear up. That was before the shots for lupus. The Dr. was surprised but thought the prednisone and shots he gave me a few years later wouldn't cause a reaction. He did apologize but said cortisone reactions were so rare he just didn't think it would happen in a different form. I don't know if this is related but suspect it is since cortisone is involved in the treatment of CAH

Has anyone else run into this? I don't even know if it is related to being bi-gendered.

I'd appreciate any help or information I can get-I know no one can diagnose but just hearing from others will help.

I don't have and can't get health insurance because of the lupus plus my county-yes the entire county has only 1 LBGT and no transgendered so I won't get help around here.

JJ

[Guest Nikklo]

Wow, I find my place. My name is Nikky and I have 2 urethras, also. No one told me about it. I came here to learn how to live with this discovery.

[Bulldog1948]

Hi Nikky,

Yes, this is now your place. As you can see, other members that are intersexed, are beginning to converse.

Being intersexed is a complicated situation and oftentimes involves many different medical factors. I can't remember off the top of my head, how many different intersex conditions that are now known to exist, but there are quite a few of them. Some people who feel and almost know that they are intersexed cannot afford all of the medical tests that are involved to get a true diagnosis and that's a shame.

Mike

[Guest Crossroads]

So I haven't looked up a lot of intersex information before, outside of my biology classes and activism work. I was met when I first started looking into transgender things with "every trans* person thinks they are intersex", and therefore never even thought to look into it. Reading your post, JJ, I was a little confused, so I looked up a little more.

I've never looked or had anyone look for a second urethra or any intersex condition, and I've only had one GYN visit that was at a low-income clinic. I started Testosterone before I ever could have gotten pregnant. And since most of my dysphoria lies in this area of my body, I'd never thought to even explore any of these things. But I'm amazed at the similarities I am seeing as well as much of what I've been reading. It'd be different if it were one or two things similar, but I'm seeing only one or two things that are NOT similar, the more I look.

Of course, I may not be able to afford any sort of investigation into this until I finish graduate school in 10 years. Perhaps this might be an interesting thing to look into someday. Thanks for posting your story so long ago, JJ. I learned something!

[Guest JayHL]

HI all

I work with children and can confirm that dual urethra is relatively rare. Urogenital malformations are usually congenital, and are the result of imperfect, incomplete or non-istandard development. The condition is more common in males, but there are occurrences in females. The cause is unknown. The problem with health statistics is that references in medical literature are based on clearly recorded diagnoses which, in some conditions are often the tip of the iceberg. Many people go through life unaware that their anatomy is different from what is considered as ‘standard’. Research into variation in human anatomy reveals that variation from baseline standard is as common as 1 in 100.

Most people have one urethra and two ureters (each ureter carries urine from one kidney to the bladder) The most frequent variation of renal duplication is in cases of a horseshoe-shaped kidney containing 2 excretory systems and 2 ureters (frequency is about one in 500 children). This occurs when two kidneys fuse together appearing as a horseshoe-shaped organ.

Compared to dual urethra, duplication of the ureter is one of the most common congenital malformations of the urinary tract with duplication found in 0.9% of cases. This condition is more common in females. There are often no symptoms as such, but there may be persistent or recurrent urinary tract infections.

JJ you are probably aware of the causes of CAH, but for the benefit if other readers salt-wasting Congenital Adrenal Hyperplasia (CAH - which can affect males and females) is usually due to a deficiency in an enzyme steroid known as 21-Hydroxylase. The condition carries with it a deficiency in production of cortisol and aldosterone. Aldosterone is necessary for normal retention of sodium by the kidneys, and in its absence, a "salt wasting" disorder occurs. Infants with the salt-wasting variation lose large amounts of sodium in urine, which leads to potentially fatal electrolyte and water imbalance leading to dehydration which as most people are aware, is life threatening.

The absence of the enzyme 21-hydroxylase, results in a substantial increase in the concentration of another 17-hydroxyprogesterone (a steroid hormone) which is then converted to androgens including testosterone and dihydrotestosterone.

Dihydrotestosterone (DHT) is the more potent form of testosterone which is essential for the virilisation of a genetically male fetus. This is why genetically female infants with CAH present with over-developed genitalia (sometimes to the degree in which their phallus is enlarged to a size commensurate with a penis and the outer labia have fused to resemble a scrotum.

Another, much rarer variation which can include salt-wasting occurs when the deficiency is traced to the lack of the enzyme 3 beta-hydroxysteroid dehydrogenase (sorry about the long names!).