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Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis.
BMC Urol. 2019 Apr 03; 19(1):21.BU

Abstract

BACKGROUND

It has been recognized that the incidence of prostatic utricle in boys is increasing and is closely associated with diseases such as hypospadias. However, the clinical features of prostatic utricle with normal external genitalia have received little attention.

METHODS

Based on this, a series of 22 male children with prostatic utricles has been compiled by adding our 3 patients to 19 cases reported. All children enrolled had normal external genitalia. Clinical data of the case was reviewed.

RESULTS

Urinary tract infection, purulent urethral discharge and pyuria were the most common presenting chief complaint (41%), irritative lower urinary tract symptoms were present in 17% of cases, obstructive lower urinary tract symptoms were noted in 14%. Urinary retention has been reported in 18% and epididymitis has been reported in 14%. Relatively rare clinical symptoms are abdominal pain, hematuria, and hematospermia. A case of calculus formation and a case of neoplasia within the prostatic utricle has been reported. A cystic mass found by digital rectal examination is the most common presenting sign. A utricular lesion posterior to the bladder was revealed by imaging examination. Unilateral renal agenesis was associated in 32% of reports. Non-surgical approach was chosen in 3 cases, transrectal ultrasonography guided aspiration has been reported in 1 case. Endoscopic techniques were used in 3 cases. Open excision was used in 11 cases. The laparoscopic excision was chosen in 3 cases and Robot-assisted laparoscopy was reported in 1 case. Symptoms and signs disappeared after treatment in all children, and no recurrence occurred during follow-up.

CONCLUSIONS

Prostate utricles without external genital anomalies are rarely reported in children, and are easily missed and misdiagnosed, often accompanied by recurrent urinary tract infections, lower urinary tract symptoms, epididymitis, dysuria and other symptoms. Imaging studies can confirm the diagnosis. Symptomatic and large utricles should be actively treated. The treatment program should be based on the age, clinical symptoms, and size and location of the utricle.

Links

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Authors+Show Affiliations

Liu B
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, 400014, China.
He D
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China. 400116@hospital.cqmu.edu.cn. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, 400014, China. 400116@hospital.cqmu.edu.cn.
Zhang D
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China.
Liu X
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China.
Lin T
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, 400014, China.
Wei G
Department of Urology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, 400014, China.

MeSH

AdolescentChildChild, PreschoolGenitalia, MaleHumansHypospadiasInfantMaleProstateUrogenital Abnormalities

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

30943976

Citation

Liu, Bo, et al. "Prostatic Utricles Without External Genital Anomalies in Children: Our Experience, Literature Review, and Pooling Analysis." BMC Urology, vol. 19, no. 1, 2019, p. 21.
Liu B, He D, Zhang D, et al. Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. BMC Urol. 2019;19(1):21.
Liu, B., He, D., Zhang, D., Liu, X., Lin, T., & Wei, G. (2019). Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. BMC Urology, 19(1), 21. https://doi.org/10.1186/s12894-019-0450-z
Liu B, et al. Prostatic Utricles Without External Genital Anomalies in Children: Our Experience, Literature Review, and Pooling Analysis. BMC Urol. 2019 Apr 3;19(1):21. PubMed PMID: 30943976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. AU - Liu,Bo, AU - He,Dawei, AU - Zhang,Deying, AU - Liu,Xing, AU - Lin,Tao, AU - Wei,Guanghui, Y1 - 2019/04/03/ PY - 2019/01/30/received PY - 2019/03/24/accepted PY - 2019/4/5/entrez PY - 2019/4/5/pubmed PY - 2019/12/18/medline KW - Children KW - External genital anomalies KW - Prostatic utricle cyst SP - 21 EP - 21 JF - BMC urology JO - BMC Urol VL - 19 IS - 1 N2 - BACKGROUND: It has been recognized that the incidence of prostatic utricle in boys is increasing and is closely associated with diseases such as hypospadias. However, the clinical features of prostatic utricle with normal external genitalia have received little attention. METHODS: Based on this, a series of 22 male children with prostatic utricles has been compiled by adding our 3 patients to 19 cases reported. All children enrolled had normal external genitalia. Clinical data of the case was reviewed. RESULTS: Urinary tract infection, purulent urethral discharge and pyuria were the most common presenting chief complaint (41%), irritative lower urinary tract symptoms were present in 17% of cases, obstructive lower urinary tract symptoms were noted in 14%. Urinary retention has been reported in 18% and epididymitis has been reported in 14%. Relatively rare clinical symptoms are abdominal pain, hematuria, and hematospermia. A case of calculus formation and a case of neoplasia within the prostatic utricle has been reported. A cystic mass found by digital rectal examination is the most common presenting sign. A utricular lesion posterior to the bladder was revealed by imaging examination. Unilateral renal agenesis was associated in 32% of reports. Non-surgical approach was chosen in 3 cases, transrectal ultrasonography guided aspiration has been reported in 1 case. Endoscopic techniques were used in 3 cases. Open excision was used in 11 cases. The laparoscopic excision was chosen in 3 cases and Robot-assisted laparoscopy was reported in 1 case. Symptoms and signs disappeared after treatment in all children, and no recurrence occurred during follow-up. CONCLUSIONS: Prostate utricles without external genital anomalies are rarely reported in children, and are easily missed and misdiagnosed, often accompanied by recurrent urinary tract infections, lower urinary tract symptoms, epididymitis, dysuria and other symptoms. Imaging studies can confirm the diagnosis. Symptomatic and large utricles should be actively treated. The treatment program should be based on the age, clinical symptoms, and size and location of the utricle. SN - 1471-2490 UR - https://www.unboundmedicine.com/medline/citation/30943976/Prostatic_utricles_without_external_genital_anomalies_in_children:_our_experience_literature_review_and_pooling_analysis_ DB - PRIME DP - Unbound Medicine ER -