What is urethral cleft? What is the treatment and effect of urethral cleft? I. Causes In the 8th week of embryo, the genital nodes of the lower part of the anterior abdominal wall forming the penis are displaced too far backward, and the position of the urogenital groove connected to the end of the urogenital sinus is forward, so that the urethra formed later is located on the dorsal side of the penis, and if the urogenital groove does not converge in the midline, it forms supraurethral cleft. According to the position of the opening of the urethra on the dorsal side of the penis, male urethral cleft can be divided into 3 types. 1. Penile head type: The urethra opens in front of the dorsal coronary sulcus of the head of the penis. We sometimes find atypical supraurethral cleft during penile examination, such as occult penile examination, and after turning up the foreskin, it is found to be supraurethral cleft. This type usually does not have urinary incontinence, and the appearance looks like a short penis. 2.Penile body type: The urethral opening is anywhere between the dorsal side of the penile body, the root of the penis to the coronal groove, this type is the most common. 3.Complete type: The urethra opens at the bladder neck, and some even have different degrees of bladder exstrophy and pubic symphysis separation, and the external urethral sphincter and bladder neck muscles are underdeveloped. The complete type is accompanied by urinary incontinence. The pathological changes of supraurethral cleft include the following three aspects: 1. The position of the urethra is anomalous It is located above the penile corpus cavernosum on the dorsal side of the penis. The anterior wall of the urethra is defective to varying degrees The defective urethra is sulcus-shaped and covered with urethral mucosa. 3, short penis, dorsal flexion, flat and wide penile head, spade shape, lack of foreskin dorsal side but more ventral side. The typical urethral cleft in children with penile dorsiflexion is obvious, urination is like a fountain, sometimes urine is shot into the face of the child, because the penis is dorsally flexed, normal sexual life cannot be carried out, the absence of the urethra leads to the inability to ejaculate, so urethral cleft regardless of the type must be surgically treated, the treatment of urethral cleft needs to achieve the purpose: firstly, to achieve normal urination, followed by the maintenance of normal sexual intercourse and reproductive function. In order to achieve these goals, it is necessary to perform: 1) urethral reconstruction; 2) correction of penile dorsiflexion deformity; 3) bladder neck shaping. IV. Prognosis Surgical treatment of supraurethral cleft is difficult and has a high failure rate. Common surgical complications include urethral fistula, wound dehiscence, urethral stricture, urethral distortion, and inability to ejaculate. In some cases, urinary incontinence remains after surgery. Due to the many complications and the complexity of treatment, there are urinary diversions for severe supraurethral cleft, such as ileal substitution cystectomy or rectal substitution cystectomy.