Double Urethra

Urethral duplication, or double urethra, is a very rare condition – only about 200 cases have been described in medical literature.


My son was diagnosed with a double urethra when he was 3 months old. He has two holes in his penis. He was also diagnosed with Reflux III. He was on antibiotics until he was 15 months old. He has never had a bladder infection. At 9 months he had his second voiding cystourethrogram (ed. — X ray while he’s peeing), and it showed no signs of the reflux, but the second urethra extending from the bladder was much more predominant. Is there anything that can be done or should be done for a double urethra. He only urinates from one hole. I am concerned that the urine in the second urethra will cause infections.
Mary Padilla – Santa Maria, California

Dr. Greene's Answer

The urinary system is both amazing and complex. Urine is formed in the kidneys by their filtering the blood. The kidneys are located in the back, just under the ribs. A tube called a ureter extends from each kidney down to the bladder. As the urine is formed, it flows down these tubes and is stored in the bladder. Urine leaves the bladder and exits the body through a tube called the urethra.

In girls the urethra is short and straight; in boys the urethra is long, and S-curved. The final portion travels the length of the penis, and typically opens at the hole in the tip.

The formation of the male urethra in utero is complex, and not completely understood. This development can go awry in a number of ways, including part or all of the urethra in the wrong location, valves blocking urine flow, or dilatation so that flow isn’t blocked when it should be. Some boys even have two urethras.

Rarity of Double Urethra

Urethral duplication is a very rare condition – only about 200 cases have been described in medical literature. Urethral duplications occur in many varieties and seem to come from many different abnormalities of development.

Appearance of Double Urethra

Most duplications occur with one urethra on top of the other. Occasionally, however, duplex urethras occur side by side. This is usually the case if a child has two complete penises, but also occurs if the penis is fused but widened. Most of these children have two bladders, plus two normal urethras, and only need surgery if it is needed for cosmetic reasons.

The more common situation of one urethra on top of another occurs in dorsal and ventral varieties.

In dorsal duplications of the urethra, a normal urethra follows the usual channel and ends in a normal hole at the tip of the penis. The other opening appears on the upper surface of the penis, anywhere between the tip and the base. This extra urethra may end in a blind pouch before reaching the bladder. If it does extend the entire length and insert into the bladder, the child will usually dribble urine out of this urethra, since there is no sphincter mechanism to restrain urine flow. Surgery is sometimes needed for incontinence or repeated infections. Since the normally positioned urethra has a normal bladder neck and normal sphincter mechanism, surgery consists of simply excising the extra urethra.

The ventral variety is more variable and less well understood. In some instances, two complete urethras come off the bladder; in others, the urethra bifurcates somewhere along the path. The opening from the second urethra is often located on the underside of the penis (and is thus less visible than in the dorsal variety), but it can appear further down, even as far away as the anterior rim of the anus. The closer the opening is to the anus, the more likely that this abnormally placed urethra is the normal one, with the functioning sphincter mechanism. The normally located penile urethra is often narrow, inelastic, and functions poorly, if at all. As an adult, ejaculation would also occur out of the anal urethra, not necessarily diminishing sexual pleasure, but certainly affecting fertility.

Double Urethra Treatment

Not all cases of duplex urethras need surgery, or any treatment at all. Children with duplex urethras require consultation with a pediatric urologist and individualized decisions regarding treatment. In general, perianal urethras should be repaired; the surgery is complicated and usually involves trying to move that urethra forward. If both openings are on the penis, as in your son, surgery is usually only indicated if there is a problem with incontinence, infections, or reflux (the backward flow of urine). Incontinence or isolated infections are usually present early on if they will be present at all. Reflux can be present early on, but then disappear on its own. It can, however, develop or re-develop at any time, even in adulthood, leading to infections and pressure-related kidney problems. If the two urethras lie right next to each other, the thin wall between them can give way. When the person urinates, this perforated wall can act as a flap-valve to obstruct urine flow, causing pressure back up. When undetected, this pressure can, over years, lead to renal failure, and even to kidney transplant.

For most of us, the medical conditions that afflict us as adults have their roots in childhood. Attention and appropriate medical care can prevent many of these conditions. For your son, close attention is even more important. His situation might cause him no problems (some cases of double urethra are only noticed incidentally, late in life). It could, however, progress to something serious if not followed carefully. Stay in close contact with your pediatrician and/or urologist, so that infections or reflux can be quickly treated.

Last medical review on: December 09, 2010
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

Hey there. My son (he’s 11) has a double urethra. It doesn’t seem like there is any problem with that, but he still hasn’t reached puberty, and I’m kind of worried. Should he have surgery? Is it something that can be ignored? Should I talk to his doctor? Please advise.

Hi Daniel,

I’m afraid we can’t provide medical advice here, but talking to your son’s doctor makes a lot of sense.

Best, @MsGreene
Note: I am the co-founder of, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I also have double urethra but I can still pee like normal. I don’t know what’s the function of the other hole.

Hi Dr! The problem is abt my husband. We trying to have kids bt it almost 2 years now. His got small penis wit 2 holes and everytime we having sex I don’t see his semen like I’m dry. Please help us


I’m so sorry you’re going through this. It must be hard.

This is an adult medical issue (we only deal with children’s health). Likely the best option is a urologist that specializes in double urethra and fertility.

Best, @MsGreene
Note: I am the co-founder of, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I do have the same case like this and I entire life think everyone have two hole. When I was young I talk to my friend that one for urinate and the other for sperm coming out and they just don’t get it and I think they just avoid it, lol but it turn out it just me. I’m Glade that I’m not the only one have it. XD

Due to complication in circumcision i have 2 holes in my panis apparently there is a single urethra but the urethral orifice or the hole is divided into two by a thin slit band of skin giving it appearance like to holes can it cause any complications in my sex life…

My boyfriend has your same thing and he says it never gave him problems. It looks weird but it’s normal he says. He pees and ejaculates thru both I think. He says he never had no problems but only that he wants to fix it. I think for me that is. Lol but it does look weird to me!,,,Ltd rather see a one holed penis to be honest. It’s just freaky to me, is surgery an option? Please say yes!,,,,

I was born with a Y-branched urethra and extra urethral meatus located just forward of my anus and an externally normally appearing penis and scrotum, my testes took a very long time to finish descend and never were fully developed. The exra meatus was excised and sutured closed as an infant and I underwent many sessions of urethral dilation until I was a toddler. I’ve always been sterile, never produced any detectable viable sperm but just enough testosterone to overpower the high levels of estrogen my body has produced , to create masculine secondary sex body features and halt the further development of small breasts and female hips early in purberty. I’ve had gender identity issues since childhood. Now in my 50s, I am transitioning from male to female and have recently discovered I am what’s called a 46,XX/46,XY Tetragametic Chimera. The result of fraternal twin brother and sister zygotes into one fetus with an assortment of male and female tissues composing my body. I may even have a blind uterus and ovaries as well as almost-testes, which I guess makes me a partial hermaphrodite. It took over half a century to find this out. Now I finally know who I am and why I am the way I am.

I also have this condition. I am 53 years old. It causes a forward curvature but has never really been a problem. Can I expect any issue as I get older?

I have two, one in the normal place and one about 1 millimetre back, with a thin wall separating them, literally thought this was normal until the other day. I guess it would be just the original one the developed into two. Only one is functional and I have not had any problems with the other one. It’s probably a form of hypospadias, but i cant find a type that matches what I have because I’ve only heard of accessory holes past the original and the underside of the shaft in the most extreme cases.

I am 19 have 2 holes. 1 at the top that’s not functional and 1 at the bottom of it which Functional. hahaha I thought I’m the only one who has this rare condition :D
we’re special guys haha

Hi Carl: Same for me, except that both seem to do at least SOMETHING. They both ooze out precum, but then when the main event happens, it is impossible to see where it comes from! As for urine, I think they both work, cuz once in a while, like one of the other people on here, I find that I get 2 divergent streams, and, and, like he says, if you’re standing up, where to aim CAN really be a crapshoot! In reading others on here, it seems that we’re more common than formerly thought! Is there a way we can communicate with each other to learn more about this?

I am 64 and never gave much thought to my second hole. Large on top and small on bottom. I had to be catheterized for heart bypass surgery 4 months ago. When they removed the catheter my troubles began. Peeing was extremely painful and sitting was my only option due to the spraying that began and I eventually closed up and had to be surgically reopened. I guess no one noticed it when inserting the tube and I was ripped. I now have one elongated opening and with extreme care I can stand to pee again. It must be quite rare since two urologists and my family doctor couldn’t figure out the problem and they hoped it would heal itself.

I also have two, the normal eye on top, that does nothing and one under that controls sperm and urine. Was unsure about it all till now. I also can wee at long distance as of this.

I have two holes too–one at top and one at the bottom. The top seems to be exclusively for precumming and ejaculation. The bottom is for pee, precum and ejaculation. I rarely might have a drop of pee come out the top when done peeing from bottom if lots of pee, but only seen that a few times. Only real cool thing is that precum often comes out of both holes simultaneously, keeping things moist all over. Never really noticed I had two holes and I’m in my late thirties! Cool that others have them and want to find someone with my exact crazy setup..

Our son Elohim was peeing through double hole. Could this make him uncomfortable. He is only a month old. We took him to Urologist and told us he never seen penis with 2 holes.
We were concerned and we google it. What could be the cause of the this Symptoms (double urethra)… during pregnancy period?

is there a name for this condition

I believe it’s called hypospadias

im female and have just found out i have two – im in hospital now waiting for the urologist

I also have two and both of mine are functional so standing up and peeing is kind of a crap shot

so other people have 2 urethas, I was always wondering about that, i have 2, one on top, and bottom, and i pee out of the bottom, the top one doesnt do anything but exist there.

I have 2 on top, only pee out of one, the other one if I pee hard enough it’ll dribble out