Müllerian duct remnants in the male

Persistent remnants of the caudal Müllerian duct in the male may occasionally give rise to symptoms and pose a problem of management. We describe 13 cases which have been seen over a 24-year period. In 4 cases the remnant took the form of a cyst, whilst the other 9 had tubular utricular structures. Not all had an associated maldevelopment of the genitalia and there was no relationship between the size of a tubular remnant and the degree of genital abnormality. Infection generally appeared to be related to the presence of obstruction to the free drainage of the contents of the remnant, and epididymitis occurred where free reflux into the vasa was present. Apparent incontinence was sometimes the result of urine pooling in the utricular pouch. The radiological demonstration of these structures was not always easy and in our experience voiding cystourethrography was the best means of achieving a diagnosis. Surgical excision of these structures can be difficult, and if they do not produce symptoms they should be left alone.