Müllerian duct remnant involving Wolffian system: a case report and literature review

Area of Science:

• Pediatric Urology
• Congenital Anomalies

Background:

• Recurrent acute epididymitis in infants necessitates investigation into underlying causes.
• Congenital anomalies of the genitourinary tract can present with varied urological symptoms.

Observation:

• A 14-month-old boy presented with recurrent left acute epididymitis.
• Ultrasonography revealed a retrovesical cystic mass with urethral communication.
• Cystourethrography and urethroscopy confirmed a connection to the posterior urethra via the verumontanum.

Findings:

• Biopsy of the cystic lesion showed squamous epithelium, consistent with an enlarged prostatic utricle.
• Vasography demonstrated bilateral vasa deferentia implantation into the cystic mass.
• This anatomical abnormality was identified as the likely cause of the patient's left epididymitis.

Implications:

• Enlarged prostatic utricle involving the vasa deferentia is an exceptionally rare condition.
• Surgical intervention, such as vas deferens ligation, may be necessary to manage associated epididymitis.
• This case highlights the importance of thorough diagnostic evaluation for recurrent epididymitis in pediatric patients.