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Clinical spectrum and management options for prostatic utricle in children

Alisha Gupta1, Japinder Khosa1, Andrew Barker1

  • 1Department of Paediatric surgery and urology, Perth Children's Hospital, 15, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.

Journal of Pediatric Surgery
|February 1, 2022
PubMed

Insights

Prostatic utricle (PU) is found in children with various conditions. Management varies, but individualized treatment based on anatomy leads to good outcomes.

Area of Science:

  • Pediatric Urology
  • Urogenital Development
  • Surgical Management

Background:

  • Prostatic utricle (PU) is a Mullerian duct remnant with variable clinical presentations in children.
  • It can be associated with hypospadias, posterior urethral valves (PUV), and other genitourinary anomalies.
  • Symptomatic cases may require intervention, necessitating individualized management strategies.

Purpose of the Study:

  • To describe the clinical experience with prostatic utricle (PU) in pediatric patients.
  • To analyze the presentation, management, and outcomes of children with PU.
  • To highlight the importance of anatomical variations in planning PU treatment.

Main Methods:

  • Retrospective review of male children diagnosed with PU via cystoscopy between 2009 and 2020.
  • Exclusion of cases with variations of sex characteristics.
  • Data collection included patient presentation, interventions performed, and follow-up outcomes.

Main Results:

  • Prostatic utricle (PU) was identified in 3.4% of 1060 male children undergoing cystoscopy.
  • Common indications for cystoscopy included hypospadias (28 cases) and posterior urethral valves (PUV) (3 cases).
  • Six patients (16.7%) developed epididymo-orchitis, all with Ikoma Grade II PU, and were managed with diverse surgical and medical approaches, resulting in asymptomatic status and normal testicular volumes post-treatment.

Conclusions:

  • A range of treatment options exist for symptomatic prostatic utricle (PU), allowing for individualized surgical approaches.
  • Identifying variations in the vasal connection to the PU is crucial for successful management.
  • Individualized treatment based on clinical presentation and anatomical details ensures favorable outcomes.
Abstract

Keywords:
ChildChild LaparoscopyCystoscopyEpididymitisLaparoscopy

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