Surgical Management of Prostatic Utricle Anomalies
Summary
Prostatic utricle anomalies encompass a spectrum of congenital malformations arising from incomplete regression of the Müllerian duct remnant, manifesting as cystic dilatations or diverticula of the prostatic urethra. Although many utricles remain asymptomatic, larger or symptomatic lesions may present with recurrent urinary tract infections, lower urinary tract symptoms, epididymo‐orchitis, calculus formation or, rarely, neoplastic change. Precise diagnosis relies on imaging modalities including ultrasonography, voiding cystourethrography and magnetic resonance imaging to delineate size, location and relationship to adjacent pelvic structures. Surgical management is indicated for symptomatic or large utricles and has evolved from open suprapubic and transperineal excision to minimally invasive approaches. Endoscopic deroofing and fulguration offer a less morbid option for small lesions, whereas laparoscopy—even robot‐assisted—provides enhanced visualisation and facilitates complete excision of complex or deep‐seated utricles. Combined cystoscopic guidance and laparoscopic resection has become the preferred technique in many centres, optimising identification of the utricle ostium, preserving neurovascular structures and minimising recurrence. Long‐term outcomes demonstrate resolution of symptoms, low complication rates and minimal impact on continence or sexual function.
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Surgical Management of Prostatic Utricle Anomalies publication trend
The graph below shows the total number of articles in surgical management of prostatic utricle anomalies across all publications each year (not limited to Nature Index journals).
Technical terms
Prostatic utricle: A Müllerian duct remnant manifesting as a midline prostatic urethral diverticulum.
Laparoscopy: A minimally invasive surgical approach using small abdominal incisions and a camera to visualise and excise pelvic lesions.
Endoscopic excision: Removal of utricular tissue via instruments introduced through the urethra, often with electrocautery.
Robot‐assisted laparoscopy: Laparoscopic surgery enhanced by robotic instrumentation for precise dissection in confined spaces.
Voiding cystourethrography: Radiographic imaging of the urethra and bladder during micturition to identify diverticula and reflux.
References
- Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. BMC Urology (2019).
- Three rare etiologies of urinary retention in pediatrics: A case series and review of the literature. Clinical Case Reports (2023).
- A Rare Case of Prostatic Utricle with Crossover Vas Deferens in Children. Medicina (2021).
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