Because of the high rate of recurrence following dilation and other endoscopic approaches, the provider must maintain a high index of suspicion for recurrence when the patient presents with obstructive voiding symptoms or urinary tract infection. Research
Urethrotomy vs. urethroplasty
Comparing the two surgical procedures, a UK trial found that both urethrotomy and urethroplasty are effective in treating urethral narrowing in the bulbar region. At the same time the more invasive urethroplasty had longer-lasting benefit and was associated with fewer re-interventions. The results were integrated into the new UK guidelines on the treatment urethral narrowing by British Association of Urological Surgeons. Bioengineering
The use of bioengineered urethral tissue is promising, but still in the early stages. The Wake Forest Institute of Regenerative Medicine has pioneered the first bioengineered human urethra and in 2006 implanted urethral tissue grown on bioabsorbable scaffolding (approximating the size and shape of the affected areas) in five young (human) males who had congenital defects, physical trauma, or an unspecified disorder necessitating urethral reconstruction. As of March, 2011, all five recipients report the transplants have functioned well. Cell therapy approach through endoscopy
Buccal mucosal tissue harvested under local anesthesia after culturing in the lab when applied through endoscopy after urethrotomy in a pilot study has yielded encouraging results. This method named as BEES-HAUS procedure needs to be validated through a larger multicentric study before becoming a routine application. References


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The membrane divides the right atrium into a proximal (upper) and a distal (lower) chamber. The upper chamber receives the venous blood from both vena cavae and the lower chamber is in contact with the tricuspid valve and the right atrial appendage. Mechanism
The natural history of this defect depends on the size of the communicating orifice between the upper and lower atrial chambers. If the communicating orifice is small, the patient is critically ill and may succumb at a young age (usually during infancy) to congestive heart failure and pulmonary edema. If the connection is larger, patients may present in childhood or young adulthood with a clinical picture similar to that of mitral stenosis. Cor triatriatum may also be an incidental finding when it is nonobstructive. Diagnosis by ECHO, possibly followed by MRI. Diagnosis
Primarily diagnosed with imaging, such as echocardiogram, CT, and/or MRI. Treatment
The disorder can be treated surgically by removing the membrane dividing the atrium. References
Church WS. Congenital malformation of heart: abnormal septum in left auricle. Trans Path Soz. 1868;19:188-190.Griffith TW. Note on a Second Example of Division of the Cavity of the Left Auricle into Two Compartments by a Fibrous Band. J Anat Physiol. Apr 1903;37:255-7. [Medline].Anderson RH. Understanding the nature of congenital division of the atrial chambers. Br Heart J. Jul 1992;68(1):1-3. [Medline].Richardson JV, Doty DB, Siewers RD, et al. Cor triatriatum (subdivided left atrium). J Thorac Cardiovasc Surg. Feb 1981;81(2):232-8. [Medline].Trento A, Zuberbuhler JR, Anderson RH, et al. Divided right atrium (prominence of the eustachian and thebesian valves). J Thorac Cardiovasc Surg.