Department of Paediatric surgery and urology, Perth Children's Hospital, 15, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
Department of Paediatric surgery and urology, Perth Children's Hospital, 15, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
J Pediatr Surg. 2022 Nov;57(11):690-695. doi: 10.1016/j.jpedsurg.2022.01.013. Epub 2022 Jan 19.
Prostatic utricle (PU) has been described in children with hypospadias, posterior urethral valves (PUV), variances of sex characteristics and normal external genitalia. Intervention may be required in symptomatic cases, but clinical characteristics vary, requiring individualisation of management. We describe our experience with this condition.
Retrospective review of males noted to have PU on cystoscopy (2009-2020) at a single centre. Presentation, management and outcomes were recorded (Variances of sex characteristics excluded).
Of 1060 male children who underwent cystoscopy for various reasons, PU was recorded in 36 (3.4%), indications for cystoscopy being hypospadias in 28, PUV in 3, urinary tract infections (UTI) in 3 and hydronephrosis in 2. Six (16.7%) developed epididymo-orchitis. All 6 had Ikoma Grade II PU. Case 1 (16 years,UTI) was managed with intravenous antibiotics. Case 2 (8 years,hypospadias) underwent laying open of urethral stricture. Case 3 (5 years,PUV) underwent laparoscopic PU excision. Cases 4 and 5 (3 and 6 years, hypospadias) underwent cystoscopic injection of bulking agent near the insertion of the vasa. Case 6 (3 years,hypospadias) underwent laparoscopic PU excision with vasal disconnection (vasal openings at dome of utricle rather than base) following failed endoscopic management. Median follow-up was 36 (0-206) months. All remained asymptomatic with normal testicular volumes for age at current follow-up.
Multiple treatment options to address a symptomatic PU have been described and enable surgeons to individualise treatment based on clinical circumstances. It is important to identify variations in anatomy of vasal connection to PU to plan appropriate management.
IV (Retrospective study).
前列腺囊（PU）已在患有尿道下裂、后尿道瓣膜（PUV）、性别特征变异和正常外生殖器的儿童中描述。在有症状的病例中可能需要干预，但临床特征不同，需要个体化管理。我们描述了我们对此类疾病的经验。
对 2009 年至 2020 年间在单一中心接受膀胱镜检查的男性中发现有 PU 的男性进行回顾性研究。记录表现、治疗和结果（排除性别特征变异）。
在因各种原因接受膀胱镜检查的 1060 名男性儿童中，有 36 名（3.4%）记录有 PU，膀胱镜检查的指征为尿道下裂 28 例，PUV 3 例，尿路感染（UTI）3 例，肾积水 2 例。6 例（16.7%）发生附睾炎。所有 6 例均为 Ikoma Ⅱ级 PU。例 1（16 岁，UTI）接受静脉抗生素治疗。例 2（8 岁，尿道下裂）行尿道狭窄切开术。例 3（5 岁，PUV）行腹腔镜前列腺囊切除术。例 4 和例 5（3 岁和 6 岁，尿道下裂）行膀胱镜下注射膀胱内注射剂靠近输精管插入处。例 6（3 岁，尿道下裂）在失败的内镜治疗后行腹腔镜前列腺囊切除术和输精管切断术（输精管在囊顶而不是基底开口）。中位随访时间为 36（0-206）个月。在当前随访时，所有患者均无症状，睾丸体积正常。
已经描述了多种治疗有症状的 PU 的方法，使外科医生能够根据临床情况个体化治疗。重要的是要识别输精管与前列腺囊连接的解剖变异，以规划适当的管理。
IV（回顾性研究）。
