Prostatic utricle cyst is a rare disease which can cause recurrent genitourinary tract infections. Curran S, Akin O, Agildere AM et-al. Qiu, Yan MD; Liu, Ying MD; Ren, Wen MD; Ren, Jingjing MD*. Then the patient was given medicine and regular follow-up. Complicated and large utricles need to be cured by surgery. All cases of prostatic utricles published in English from PubMed were reviewed, the closing date was June 30, 2018. Lazarus J, Maison POM, Howlett J. Prostatic utricle cyst presenting with recurrent urethral discharge in the newborn: a case report. Cyst of the prostatic utricle: report of a case complicated by giant lithiasis. Methods Based on this, a series of 22 male children with prostatic utricles has been compiled by adding our 3 patients to 19 . Prostatic cyst is a rare disease of the prostate with 0.5% to 7.9% prevalence. Johnson D, Parikh K, Schey W, Mar W. MRI in diagnosis of a giant prostatic utricle. MeSH Introduction. This study was approved by the Ethics Committee of the Childrens Hospital of Chongqing Medical University (approval number: 2018016). Front. Of Create a new print or digital subscription to Applied Radiology. Fig.1,1, a 1414mm cystic lesion was seen within the prostate and prostatic cyst was diagnosed. Institutional Review Board approval was obtained from Research Ethics Committee of the First Affiliated Hospital College of Medicine, Zhejiang University. A utricular lesion posterior to the bladder was revealed by imaging examination. and transmitted securely. Department of Urology, Childrens Hospital of Chongqing Medical University, No. In males, the Mllerian ducts regress respond to Mllerian inhibiting factor (MIF) produced by the fetal testis, leaving them as a vestige. All the cases underwent ultrasonography and MRI. Differential diagnoses include mullerian duct cysts, bladder diverticulum, teratoma, seminal vesicle cyst, epididymal cyst and Wolffian duct cyst [1, 6]. Abbreviations: CT = computerized tomography, GP = general practitioner, MRI = magnetic resonance imaging, PSA = prostate-specific antigens. Regular long-term monitoring is recommended for all patients with prostatic utricle cyst. the contents by NLM or the National Institutes of Health. Because these utricles are very rare, with few symptoms and no specific symptoms, a correct diagnosis is difficult to establish. Apropos of 3 cases]. 3. The incidence of prostatic utricle cysts ranges around 11-14% in association with hypospadias or intersex anomalies and up to 50% in the presence of perineal hypospadias 3. AJR Am J Roentgenol. Utricle cysts do not extend above the level of the prostate base, while Mullerian duct cysts, which are discussed in detail further in the article, may. Stone composition analysis was performed in 19 of 27 patients because some patients provided fewer samples. Irritative lower urinary tract symptoms were the most common presenting complaint (42 per cent), while lower obstructive symptoms were noted in 29 per cent. a Enhanced CT shows a utricular retrovesical mass compressing the urinary bladder. Surgical management is challenging due to the close proximity of the ejaculatory ducts, pelvic nerves, vas deferens and ureters. Stuppler SA, Naranjo CA, Kandzari SJ. All his general physical examinations were normal. Recurrent genitourinary tract infections were the most frequent complaint, and two-thirds of patients also had hypospadias. Four cases were excluded due to the lack of required clinical data, and the remaining 19 cases (No. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. We also found that 32% of the cases show an association of unilateral renal agenesis, this may be due to the metanephric bud and renal blastema are in contiguity during the stage of prostatic utricle embryogenesis (7 to 8weeks) [7]. Based on the reported cases, a prostatic cyst with about 2.5cm size would make patients feel discomfort and have no abnormal laboratory test results, only regular follow-up is needed. In VCUG or RUG, the utricles may have different sizes, showing an opacified cystic structure posterior to the prostatic urethra. Related pathology prostatic utricle cyst References Related articles: Anatomy: Abdominopelvic (advertising) A novel surgical management for male infertility secondary to midline, [7]. Berrocal T, Lopez-Pereira P, Arjonilla A, Gutierrez J. Urinary retention has been reported in 18% and epididymitis has been reported in 14%. The work cannot be changed in any way or used commercially without permission from the journal. Methods: Lab investigations were within normal limits. Haematospermia is a condition that has been described for centuries by Hippocrates, Galen, Morgagni and Fournier. Prostatic utricle cyst communicates with the prostatic urethra and are located in the midline, posterior to the bladder, and anterior to the rectum, as described in this case. Diagnosis and management of ejaculatory duct obstruction. Int J Clin Exp Med 2016;9:1322730. Coronal (A) and sagittal (B) pelvic MR images of the male patient showing a well-defined midline cyst arising from the prostatic base and herniating into the urinary bladder with no clear communication with the urethra. Editorial Comment to Surgical treatment for prostatic utricle cyst in children: A single-center report of 15 patients. Although most GPs have no qualification of urology, patients with progressive symptoms, large size (2.5 cm or larger), or higher serum PSA should be referred to the specialists. The reason for choosing this option was because the symptoms of the child were first seen, and also to avoid impotency and infertility caused by surgery. As it is often asymptomatic, how to manage it is still unfamiliar with, general practitioners (GPs). 1. Please enable scripts and reload this page. HHS Vulnerability Disclosure, Help Seminal vesicle and Wolffian duct cysts are located off the midline and contain sperms [1]. Arch. Adult mllerian duct or utricle cyst: clinical significance and therapeutic management of 65 cases. [5]. Saha B, Sinha RK, Mukherjee S, et al. Exp Ther Med. 1. 2021 The Japanese Urological Association. The patient was given the medicine and regular follow-up. Urachal cysts are clearly distinguished from a prostatic utricle cyst due to their anterior relationship to the urinary bladder while seminal vesicle cysts are located lateral to midline and are usually unilateral.1. An official website of the United States government. Terms and Conditions, 2012; 110: E1084-1089. The laparoscopic excision was chosen in 3 cases and Robot-assisted laparoscopy was reported in 1 case. 2021 Jun;28(6):694-695. doi: 10.1111/iju.14562. Prostatic cyst is a rare disease of the prostate with 0.5% to 7.9% prevalence. It had been reported that MRI could demonstrate the liquid content of prostatic,[10] further MRI scan could show clear image of prostatic cyst and the result was consistent with CT scan. Symptoms varied from asymptomatic to recurrent urinary tract infections, epididymitis, hematuria, pyuria, urinary incontinence, oligospermia, lower abdominal discomfort/heaviness, urinary retention or constipation, bladder outlet obstruction, perineal pain, hematospermia, painful ejaculation,[6] irritative and/or obstructive lower urinary tracts, decreased ejaculate volume, infertility,[7] pelvic pain, or dysuria. Irritative lower urinary tract symptoms (urinary frequency, urgency, dysuria and incontinence) were noted in 6 patients (17%). Communication of the prostatic midline cyst with the prostatic urethra is typically noted.1 Surgical resection is the treatment of choice. Urinary retention has been reported in 4 patients (18%) and epididymitis has been reported in 3 patients (14%). All patients included in our study were children (age18years). Thus surgical treatment should be individualised and offered to those with persistent symptoms where other causes of similar symptoms have been are treated. The tour begins on Aug. 3 in Sterling . 2001;57(6):11515. Prostatic utricle is an uncommon congenital anomalies, with 1% incidence in autopsy findings and clinical prevalence of 5% in urologic patients [2]. Highlight selected keywords in the article text. Several days later, he recovered without lower back discomfort. Radiographics. AJR Am J Roentgenol. 422) and our own 3 cases (No. Recently robot-assisted laparoscopy was considered as an advantageous technique for the treatment of prostatic utricle [20]. Bookshelf In contrast, a Mullerian duct cyst can arise anywhere along the path of Mullerian duct regression from scrotum to utricle . The prostatic utricle is a rudimentary structure in the posterior urethra of males. Your US state privacy rights, On VCUG and RGU, prostatic utricle cyst is diagnosed when spontaneous opacification of a diverticulum arising from the prostatic urethra is seen.4 On ultrasonography, a well-defined midline cystic lesion is seen posterior to the urinary bladder. 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. However, most GPs are unfamiliar with the management. Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. DWH, TL performed relevant operations and collected patients data. Keywords Duct Cyst Ejaculatory Duct Renal Agenesis Cystic Teratoma sharing sensitive information, make sure youre on a federal As some large prostatic cysts would have high level of serum prostate-specific antigen (PSA),[2,3] it should be differentiated from other disorders such as prostatic neoplasm. Adult mllerian duct or utricle cyst: clinical significance and therapeutic management of 65 cases. This site needs JavaScript to work properly. Midline. Alpha blockers work by relaxing the smooth muscle of the bladder neck and prostate. Home An Illustrated Guide to Pediatric Urology Chapter Utricular Cyst (Prostatic Utricular Cyst) Ahmed H. Al-Salem Chapter First Online: 08 November 2016 2066 Accesses Abstract The prostatic utricle is a small, epithelium-lined diverticulum of the prostatic urethra. Clipboard, Search History, and several other advanced features are temporarily unavailable. Benign or malignant? You may search for similar articles that contain these same keywords or you may
By using this website, you agree to our Traditional open surgical approaches require high operational skills and may damage adjacent tissues [26]. 3 and 4). J Urol. Symptoms and signs disappeared after treatment in all children, and no recurrence occurred during follow-up. Case 7: neonatal prostatic utricle abscess/cyst, see full revision history and disclosures, monochorionic monoamniotic twin pregnancy, absent umbilical arterial end diastolic flow, reversal of umbilical arterial end diastolic flow, fetal middle cerebral arterial Doppler assessment, spectrum of abnormal placental villous adherence, traumatic abruptio placental scale (for CT), abnormal endometrial thickness (differential), serous type adenocarcinoma of the endometrium, clear cell type adenocarcinoma of the endometrium, mucinous type adenocarcinoma of the endometrium, prostate peripheral zone T2 hypointensity, juvenile granulosa cell tumor of the testis, abnormal testicular Doppler flow (differential), autosomal dominant polycystic kidney disease (ADPKD), autosomal recessive polycystic kidney disease (ARPKD), cystitis following radiation or chemotherapy. imperforate anus. The diagnosis is suspected when there is clinical manifestation and the mass is felt on the digital rectal examination. Prostate pain is any pain or discomfort of the prostate gland. PMC The prostate gland wraps around the tube that transports urine out of the bladder and is involved in the production of semen. 2000;16(3):199203. Federal government websites often end in .gov or .mil. National Library of Medicine Federal government websites often end in .gov or .mil. Gualco G, Ortega V, Ardao G, et al. A well-defined oval cystic lesion measuring 2 2.5 1.8 cm was noted within the prostate located in the midline, which was communicating with the prostatic urethra (Figures 1a, 1b). This makes peeing easier. Clinical dilemma arises when a patient presents with symptoms. BMC Urol 19, 21 (2019). Coppens L, Bonnet P, Andrianne R et al. ious complaints including recurrent urinary tract infection, post-voiding dribbling, urethral discharge and epididymitis [4]. SPENCE HM, CHENOWETH VC. National Library of Medicine In our case, the prostatic utricle was asymptomatic and the presenting symptoms were due to the bulbar urethral stricture. 2008;29(6):63842. Before [healthgrades.com] Asymptomatic. Berrocal T, Lpez-Pereira P, Arjonilla A, Gutirrez J. Tech Urol 1996;2:7985. Ann Diagn Pathol. Urology. 2023 BioMed Central Ltd unless otherwise stated. F. Hernndez-Galvn R, Jaime-Dvila LS, Gmez-Guerra A, et al. Keywords: 2013;33(4):112543. Urine may pool in utricle cysts, since they communicate with the urethra, occasionally resulting in post-void dribbling. However, the clinical features of prostatic utricle with normal external genitalia have received little attention. Background It has been recognized that the incidence of prostatic utricle in boys is increasing and is closely associated with diseases such as hypospadias. Renew or update your current subscription to Applied Radiology. FOIA 8600 Rockville Pike Laparoscopic excision of the prostatic utricle, owing to its safety, effectiveness, minimal invasiveness, fewer complications and rapid recovery, can be used as the first option for the treatment of prostatic utricle cyst. [Cystic prostatic utricle in adults. Received 2017 Dec 12; Revised 2018 Jan 26; Accepted 2018 Jan 31. Unable to load your collection due to an error, Unable to load your delegates due to an error. Prostatic cyst is a rare disease of the prostate especially in general practice. Bladder had normal wall thickness but had 40 ml as residual urine. The https:// ensures that you are connecting to the Inclusion in an NLM database does not imply endorsement of, or agreement with, Stones in the seminal vesicle, seminal vesicle and prostatic utricle, and prostatic utricle were detected in 59.3% (16/27), 33.3% (9/27) and 7.4% (2/27) cases respectively. Please enable it to take advantage of the complete set of features! BMC Urol. Consultant, and Dr. Garga while serving as Head of the Department of We present a case of large prostatic utricle cyst associated with urethral stricture. National Library of Medicine Women's health is once again the center of a political ping-pong match with evidence-based science on one side and anti-choice advocates on the other. 2003 Sep;19(7):557-8. doi: 10.1007/s00383-003-0993-6. Would you like email updates of new search results? 2017;4(6):3836. These funds were used in the design of the study and data collection. no financial relationships to ineligible companies to disclose. A case report of an uncommon large size of. J Androl. clear cell carcinoma or squamous cell carcinoma) with a reported prevalence as high as 3%5, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Meng X, Liu J, Yu X, Wang S, Liu C, Ye Z. All children enrolled had normal external genitalia. Epub 2021 Mar 29. 2004;34(2):1569. CASE SUMMARY A 48-year-old army officer was referred to the radiology department for MRI of prostate to rule the cause of post void dribbling. Consent for publication: The patient gave consent for publication of this case report and images. Unauthorized use of these marks is strictly prohibited. Prostatic utricle cyst with chronic prostatitis. Laparoscopic excision is feasible for symptomatic and large prostatic utricle cyst. Publication types English Abstract MeSH terms Adult Cysts / diagnosis* Cysts / surgery* Humans Magnetic Resonance Imaging Male The https:// ensures that you are connecting to the Liu BO, He D, Zhang D et al. Case Discussion This likely represents a simple prostatic cyst, which can be a Mllerian duct cyst or utricle cyst. Google Scholar. official website and that any information you provide is encrypted FOIA Another is that symptoms of the prostatic utricle are varied and nonspecific, and outpatients are often treated symptomatically without further examination to determine the underlying disease. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Treatment. Obstructive lower urinary tract symptoms (Difficulty voiding, dribbling stream and poor stream of urine) were noted in 3 patients (14%). Pediatr Radiol. Before 1 Introduction Thanks to the widespread use of prostatic transrectal ultrasound (TRUS) scanning in uro-andrological practice today, there has been an increase in the incidental diagnosis of cystic lesions of the prostate; the mean rate is now 5 % (range 0.5-7.9 %) in patients with lower urinary tract symptoms (LUTS) [ 1 ]. Cystic lesions of the prostate gland: an ultrasound classification with pathological correlation, Benign or malignant? Wasim AM, Muhammad SK, Abdus S. Enlarged prostatic utricle cyst with incidental finding of renal agenesis: a case report and literature review. The clinical presentation of utricular cysts is variable and includes pelvic mass, obstructive and irritative urinary tract symptoms, hematuria, and suprapubic or rectal pain. Utricular Cyst (Prostatic Utricular Cyst) (1) Pediatric Surgery, AlSadik Hospital, Qatif, Saudi Arabia 20.1 Introduction The prostatic utricle is a small, epithelium-lined diverticulum of the prostatic urethra. After . Before official website and that any information you provide is encrypted Urology. Photo: Andreas Neumann. 2008;2(1):3941. The meatus was at ventral surface of glans and of adequate calibre. Results: J Urol. https://doi.org/10.1186/s12894-019-0450-z, DOI: https://doi.org/10.1186/s12894-019-0450-z. The cyst measured 1.6*1.3 cm and exhibited bright T2 signal intensity and hypo intense T1 signal intensity with peripheral wall enhancement characteristic of a cyst (red arrow). 1, 2). Epub 2003 Sep 6. You may be trying to access this site from a secured browser on the server. They are midline cystic masses in the male pelvis and can be very difficult or impossible to distinguish from a Mllerian duct cyst. Radiographics. Figure 1: Ascending urethrogram: Horizontal arrow showing utricle cyst, solid arrow showing distal bulbar stricture, Figure 2: Voiding Cysturethrogram showing utricle cyst posterior to bladder and communicating with prostatic urethra. PubMed As our patient is unmarried and has no symptom of hematospermia, genital examination, semen analysis, and culture was not conducted. Transrectal ultrasound (TRUS) of the prostate gland and seminal vesicles using the new high-frequency, high-resolution probes plays an important role in the diagnosis and management of male infertility and hematospermia [1], [2]. And the clinical manifestations depend on the size of the cyst. Prostatic utricle is a remnant of Mullerian duct in males.1 Utricle is derived from the Latin word pouch, which forms a cul-de-sac 6 mm long, located in the verumontanum between the two ejaculatory ducts that projects upward and backward into the substance of the prostate. Some patients may be asymptomatic. [4] According to Mou et al,[5] the etiological factors of prostatic cysts include inflammatory disease, benign prostatic hyperplasia, ejaculatory duct obstruction, atrophy of the prostate gland, and tumor. Please try after some time. 4. Since no single series has been amassed for analysis, the clinical features, symptoms and signs of these patients, and how to deal with them have not been well characterized. Oral informed consent was obtained from the patient for publication of this report. Your message has been successfully sent to your colleague. Conclusion: BJU Int. The .gov means its official. As a library, NLM provides access to scientific literature. For more information, please refer to our Privacy Policy. Enlarged prostatic utricles (grade II and III), which often requires surgical intervention, are easily detected by ultrasound, RUG and VCUG [24]. Prostatic cyst: an unusual cause of hemospermia, Clear cell adenocarcinoma of the prostatic utricle in an adolescent. Abdom Imaging. There was no history of trauma or infection in the past. Digital rectal examination revealed a large firm non-tender midline swelling in the prostate. As the biopsy in our case was not performed, the types here could not be clarified. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bethesda, MD 20894, Web Policies An official website of the United States government. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love Chen HK, Pemberton R. A large, benign, [4]. 2009;6. Surgical management of enlarged prostatic utricle. Mou P, Zijun W, Mao D, et al. However, it is worth noting that the identification of the prostate utricle by VCUG or RUG is often missed because the utricle is not fully filled, and the small prostate utricle is not easily detected by ultrasound. ultrasound Ultrasound The patient is scanned with a full bladder. A 48-year-old army officer was referred to the radiology department for MRI of prostate to rule the cause of post void dribbling. [1] A total of 3% to 7.5% of asymptomatic patients have medial cysts. Published by Wolters Kluwer Health, Inc. utricle cysts may contain pus or hemorrhage if infected, utricle cysts may contain cancer (e.g. Smoothie. Med. Unable to process the form. Laparoscopic excision of prostatic utricle is suitable for surgeons who are skilled in advanced laparoscopic techniques. Un programa que dej de tener gracia cuando se. Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. Laparoscopic excision of a prostatic utricle in a child. JPSS. Endoscopic cannulation of the utricular opening with contrast material infusion into the cyst is another method to accurately demonstrate the communication of the urethra with the mass, and can determine the anatomical relationship with surrounding structures [1]. Prostatic utricle cyst is a rare midline cystic lesion between the urinary bladder and the rectum, commonly associated with hypospadias. Squamous metaplasia complicating a mllerian duct remnant. Although it has been reported by some urological specialists, to our knowledge, this is the first case report and literature review that conclude how to do when a general practitioner (GP) encountered patients with prostatic cyst. Conclusions: After careful embryological investigation, the researchers believe that the cranial portion of the prostatic utricle is derived from the Mllerian ducts and the caudal segment has a mixed origin from the Mllerian ducts and Wolffian ducts and the urogenital sinus [13]. Cite this article. Rare combination of unilateral renal agenesis, congenital obstructive posterior urethral membrane, and enlarged prostatic utricle, with absence of hydroureteronephrosis. Symptomatic and large utricles should be actively treated. Clinical characteristics and management were collected and catalogued. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. As some large prostatic cysts would have high level of serum prostate-specific antigen (PSA),[2,3] it should be differentiated from other disorders such as prostatic neoplasm. 1995;164 (1): 123-7. An unusual and rare cause of recurrent epididymitis in an infant. Front Med. Since the patients included have been discharged when the study began, verbal consent was obtained from all study participants/their parents. Zu XB, Chen MF, Ye ZQ, Zhou SW, Qi L, Zhang XY. Accessibility FOIA CAS The data of the current study are available from the corresponding author on reasonable request. As shown in Fig. 3. Please enable it to take advantage of the complete set of features! Several days later, he recovered without the lower back discomfort and no other symptoms were observed. [12]. volume19, Articlenumber:21 (2019) Through the case report and literature review, patients with prostatic cyst of small size and no symptom should have routine follow-up. Urethrocystoscopy revealed an orifice opening into a utricle in 10 cases. In some cases, prostatic utricle is markedly enlarged and present as a cystic lesion in perineum or in pelvic cavity posing diagnostic dilemma. Although prostatic cyst of progressive symptoms, large size (2.5cm or larger), or high serum prostate-specific antigen (PSA) should be timely referred to urological specialists. APSP journal of case reports. Prostatic utricle cyst is a rare disease which can cause recurrent genitourinary tract infections. Prostatic cyst is a rare disease of the prostate with 0.5% to 7.9% prevalence. A connection between the posterior urethra and the prostatic utricle cyst was found in all cases. After the physical examination, abdominal ultrasonography was performed. J. Urol. Prostatic utricles without external genital anomalies in children: our experience, literature review, and pooling analysis. Apart from the clinical manifestations, imaging technology such as ultrasound, CT, and MRI could assist the diagnoses. Kojima Y, Hayashi Y, Maruyama T, Sasaki S, Kohri K. Comparison between ultrasonography and retrograde urethrography for detection of prostatic utricle associated with hypospadias. BMJ Case Rep. 2013;2013. One is that the majority of prostatic utricles are asymptomatic, especially when small, thus symptomatic prostatic utricles are easily misdiagnosed or never diagnosed. Issa MM, Kalish J, Petros JA. and transmitted securely. The .gov means its official. All his general physical examinations were normal. Prostatic utricle cysts tend to be smaller (less than 10 mm) in size. 2013;5(2):12931. 2009 Aug;15(8):721-3. Very few cases have been reported in the literature. Become a Gold Supporter and see no third-party ads. Conclusions. b Delayed enhanced CT shows the bladder filled with contrast agent, a large utricular mass located behind and in close proximity to the urinary bladder, Magnetic resonance image shows a large prostatic utricle (white arrow) behind the urinary bladder (white arrowhead). Seminal vesicle cysts result from congenital atresia of the ejaculatory duct and are often associated with ipsilateral renal agenesis [7]. Results: The incidence of prostatic utricle cysts ranges around 11-14% in association with hypospadias or intersex anomalies and up to 50% in the presence of perineal hypospadias 3. For the treatment of choice, Search History, and two-thirds of patients had! Physical examination, abdominal ultrasonography was performed, abdominal ultrasonography was performed gualco G, et al 4 ).. 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