Acimi Smail, Abderrahmane Naima, Debbous Lamia, Benabadji Nadjia, Acimi Mohammed Ali
Department of Visceral Surgery, Faculty of Medicine, Children's Hospital Canastel, University of Oran, Oran, Algeria.
Department of Endocrinology, Faculty of Medicine, CHU of Oran, University of Oran, Oran, Algeria.
World J Urol. 2023 Feb;41(2):595-600. doi: 10.1007/s00345-022-04273-z. Epub 2023 Jan 2.
To determine the prevalence, radiological characteristics, and clinical symptomatology of enlarged prostatic utricles and vagina masculinus in boys with disorders of sex development.
Over 10 years (from February 2012 to March 2022), 102 boys with severe hypospadias underwent voiding cystourethrography. All patients presented with disorders of sex development and Y material in the karyotype (46,XY karyotype, 46,XY/45,X mosaic, etc.). The age of the patients at the first examination ranged from 4 days to 27 months (mean age 2.7 months).
Voiding cystourethrography revealed the presence of a cyst posterior to the urethra in 66 patients (64.7% of cases). There were 15 cases of "vagina masculinus" and 51 of enlarged prostatic utricles. These dilations were classified according to the Ikoma classification and cyst size. In more than 2/3 of cases, the cysts were small (less than 20 mm), and in less than 8% of cases, these cysts were large. In addition, retrograde opacification revealed the presence of vesicoureteral reflux in 20% of boys with a male vagina. The most severe hypospadias with a scrotal or perineal meatus are most at risk of developing an enlarged prostatic utricle, and 80% of patients with Ikoma Grade III had a scrotal or perineal meatus.
This study shows that the prevalence of enlarged prostatic utricles and vagina masculinus is high in patients with severe hypospadias. Therefore, their search should be systematic, and for clinical and therapeutic interest, the enlarged prostatic utricles should be classified according to cyst size.
确定性发育障碍男孩中前列腺囊和男性阴道增大的患病率、放射学特征及临床症状。
在10年期间（2012年2月至2022年3月），对102例重度尿道下裂男孩进行了排尿性膀胱尿道造影。所有患者均表现为性发育障碍且核型中有Y物质（46,XY核型、46,XY/45,X嵌合体等）。首次检查时患者年龄为4天至27个月（平均年龄2.7个月）。
排尿性膀胱尿道造影显示66例患者（64.7%）尿道后方存在囊肿。其中“男性阴道”15例，前列腺囊增大51例。这些扩张根据池间分类法和囊肿大小进行分类。超过2/3的病例囊肿较小（小于20mm），不到8%的病例囊肿较大。此外，逆行造影显示20%有男性阴道的男孩存在膀胱输尿管反流。阴囊或会阴尿道外口的重度尿道下裂患者发生前列腺囊增大的风险最高，池间III级患者中有80%有阴囊或会阴尿道外口。
本研究表明，重度尿道下裂患者中前列腺囊和男性阴道增大的患病率较高。因此，应系统地进行检查，出于临床和治疗目的，应根据囊肿大小对增大的前列腺囊进行分类。
