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Laparoscopic excision of a prostatic utricle in a child
I E Willetts1, J P Roberts, A E MacKinnon
1Department Paediatric Surgery, Sheffield Children's Hospital, Sheffield, UK. gcq82@dial.pipex.com
Insights
Prostatic utricle cysts, often seen with hypospadias, can cause urinary issues. Laparoscopic excision offers a safe, minimally invasive surgical option for symptomatic pediatric cases.
Area of Science:
- Pediatric Urology
- Surgical Innovation
Background:
- Prostatic utricle cysts arise from incomplete Mullerian duct regression.
- They frequently co-occur with hypospadias in males.
Observation:
- Symptomatic presentations include UTIs, pain, incontinence, abdominal masses, and epididymitis.
- Traditional treatments involve open or endoscopic surgical techniques.
Findings:
- Laparoscopic excision provides a successful, minimally invasive approach for pediatric prostatic utricle cysts.
- Utilizing a cystoscope aids in precise identification and dissection.
Implications:
- Laparoscopic excision is a safe and effective alternative to open surgery for symptomatic pediatric cysts.
- This technique may reduce patient morbidity and recovery time.
Abstract:
Prostatic utricle cysts result from incomplete regression of Mullerian duct structures and occur most frequently in males with perineal or peno-scrotal hypospadias. Utricular cysts may present with various signs and symptoms including urinary tract infection, pain and post-void incontinence, a palpable abdominal mass or recurrent epididymitis. Treatment is reserved for symptomatic cysts and various techniques have been described including transurethral deroofing, endoscopic incision or surgical excision by suprapubic, posterior and midline transvesical approaches. We present a successful minimally invasive approach for excision of a prostatic utricle cyst in a child. Laparoscopic excision is a safe and viable alternative to open procedures in the surgical treatment of symptomatic utricle cysts in childhood. The presence of a cystoscope within the utricle orifice aids identification and safe dissection of the utricular remnant.
