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儿童前列腺囊囊肿的外科治疗:单中心 15 例报告。

Surgical treatment for prostatic utricle cyst in children: A single-center report of 15 patients.

机构信息

Department of Urology, Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Int J Urol. 2021 Jun;28(6):689-694. doi: 10.1111/iju.14543. Epub 2021 Mar 29.

Abstract

OBJECTIVES

To report our single-center experience of the management of children with prostatic utricle cysts.

METHODS

We retrospectively analyzed 15 children who were incidentally found to have a prostatic utricle cyst and were admitted to our department between October 2013 and August 2020. Clinical characteristics and management were collected and catalogued.

RESULTS

Recurrent genitourinary tract infections were the most frequent complaint, and two-thirds of patients also had hypospadias. A connection between the posterior urethra and the prostatic utricle cyst was found in all cases. Two patients directly had their progressively enlarging prostatic utricle cyst resected laparoscopically. Endoscopic techniques were used in 13 patients, two of whom underwent laparoscopic excision for repeated symptoms. The mean (range) follow-up period was 34.9 (2-82) months. No recurrences were observed in four patients who underwent prostatic utricle cyst excision and eight patients who received endoscopic treatment. Three patients had recurrent symptoms after endoscopic treatment and were managed by nonsurgical treatment.

CONCLUSIONS

Prostatic utricle cyst is a rare disease which can cause recurrent genitourinary tract infections. Extra attention should be paid to evaluation for prostatic utricle cyst in children with external genital anomalies. Retrograde urethrogram and magnetic resonance imaging are useful tools with which to distinguish prostatic utricle cyst from other cystic lesions that are located in the midline pelvis in male patients. Individualized treatment is appropriate when considering fertility preservation, recurrences and malignancy. Laparoscopic excision is feasible for symptomatic and large prostatic utricle cyst. Regular long-term monitoring is recommended for all patients with prostatic utricle cyst.

摘要

目的

报告我们单中心处理前列腺囊 肿患儿的经验。

方法

我们回顾性分析了 2013 年 10 月至 2020 年 8 月期间因偶然发现前列腺囊 肿而收入我科的 15 例患儿。收集并分类了临床特征和治疗方法。

结果

复发性下尿路感染是最常见的主诉,三分之二的患者还伴有尿道下裂。所有病例均发现后尿道与前列腺囊 肿之间有相通。2 例患者直接行腹腔镜下逐渐增大的前列腺囊 肿切除术。13 例患者采用内镜技术,其中 2 例因症状反复而行腹腔镜切除。平均(范围)随访时间为 34.9(2-82)个月。行前列腺囊 肿切除术的 4 例和接受内镜治疗的 8 例患者均无复发。4 例行前列腺囊 肿切除术的患者和 8 例行内镜治疗的患者中,有 3 例患者在接受内镜治疗后出现复发症状,经非手术治疗后缓解。

结论

前列腺囊 肿是一种罕见疾病,可引起复发性下尿路感染。对于存在外生殖器异常的患儿,应特别注意前列腺囊 肿的评估。逆行尿道造影和磁共振成像有助于将前列腺囊 肿与男性患者中位于中线骨盆的其他囊性病变区分开来。在考虑生育力保留、复发和恶性肿瘤时,应采用个体化治疗。对于有症状和较大的前列腺囊 肿,腹腔镜切除是可行的。建议所有前列腺囊 肿患者进行定期的长期监测。

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