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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.

Objectives To clarify the relationship between midline cyst formation and second to fourth finger length ratio. Methods The present study included 95 benign prostatic hyperplasia patients and 61 healthy male college students. All midline cysts were identified by transrectal ultrasonography. In the benign prostatic hyperplasia group, 45 midline cyst (+) men (Mage = 67.2 years) and age-matched 50 midline cyst (−) men (Mage = 67.1 years) were included. In the university student group, 12 midline cyst (+) men (Mage = 21.7 years) and age-matched 49 midline cyst (−) men (Mage = 21.1 years) were included. We took photocopies of the participants' bilateral hands, and measured the second and fourth finger length was measured by one examiner in a blind manner. Results Second to fourth finger length ratios in the benign prostatic hyperplasia group (right/left mean ± SD) were higher bilaterally in midline cyst (+) (0.95 ± 0.03/0.95 ± 0.03) than those in midline cyst (−) (0.92 ± 0.03/0.92 ± 0.03; P

Background: We examined so-called Mullerian duct cysts both histologically and immunohistochemically with anatomical observation to investigate the etiology of the ‘Mullerian duct cyst’. Methods: Five cystic lesions located in the prostatic midline were obtained from surgical specimens. A communication between the cystic lesion and the urethra via the utricular orifice was looked for and the specimens were subjected to histological and immunohistochemical testing. Results: A communication between the cyst and the urethra was confirmed in four cases, but not in one case. Histological and immunohistochemical examinations of the epithelium lining indicated that its characteristics were identical to those of the prostatic utricle in all cases. Conclusions: The so-called Mullerian duct cyst exhibits features comparable to those previously described in the prostatic utricle. There is no evidence that these cystic lesions originate from the Mullerian duct remnant, at least in the epithelial lining. We suggest that they should be termed a prostatic utricular cyst or cystic dilation of the prostatic utricle, depending on whether an outlet to the urethra is absent or present, respectively.

Objective To report our experience of laparoscopic excision of symptomatic prostatic utricles in children. Patients and methods Prostatic utricles were excised laparoscopically in four boys (mean age 6.3 years, range 1.5–17). Cysto-urethroscopy and cannulation of the prostatic utricle was initially undertaken with a cystoscope that was left in situ inside the prostatic utricle to facilitate subsequent identification and mobilization during the laparoscopic procedure. Laparoscopy was conducted via a 5-mm port inserted through a supra-umbilical incision. Two more 5 mm working ports were inserted at the right and left mid-abdomen. The prostatic utricle was easily identified with the guidance of cystoscopic transillumination. Dissection was further facilitated by lifting and counter-traction of the prostatic utricle using the indwelling cystoscope. The prostatic utricle was completely mobilized and divided at its confluence with the urethra using an ultrasonic scalpel. Results Laparoscopic excision of the prostatic utricle was successful in all four patients. The urethral defect was closed by intracorporeal suturing in three patients while the defect was small enough to be adequately closed by ultrasonic coagulation in one. One patient also had a nonfunctioning dysplastic kidney associated with an ectopic ureter joining into the prostatic utricle, and underwent nephroureterectomy at the same setting. The mean (range) operative duration was 148 (105–225) min. All four patients recovered uneventfully with no complications. Conclusions Laparoscopic excision under cystoscopic guidance is effective for symptomatic prostatic utricles, offering a good surgical view and allowing easy dissection in a deep and narrow pelvic cavity.

We investigated the utriculus prostaticus from the fetal period up to adulthood in 148 prostates. During the second half of gestation the utriculus had a simple tubular or a cystic form and was lined with metaplastic squamous epithelium which showed immunohisto-chemical positivity for different keratins, carcinoembryonic antigen, and peanut agglutinin binding sites. After birth, alveolar outgrowths of the utriculus developed. After puberty, the utriculus had become a complicated and variable structure. The epithelium no longer differed from that of the prostate glands either morphologically or immunohistochemically. Within the epithelium numerous endocrine cells were found containing neuron-specific enolase, chromogranin, and serotonin. The utriculus and ejaculatory ducts were embedded in a fibrous stroma with, after birth, numerous plexus-like blood vessels. This fibrous zone was peripherally bordered by a layer of smooth muscle. There was no evidence for a function of the utriculus differing from that of the prostate glands. Since the epithelium of both structures is identical immunohistochemically, the epithelium of the sinus urogenitalis most likely participates in the lining of the utriculus during embryogenesis.

With the increased number of prostatic specimens submitted for pathologic examination, the variety of lesions discovered in the processed tissue has widened. In addition to the characteristic patterns of “benign prostatic hypertrophy” and the usual ones in primary adenocarcinoma of the prostate, other lesions not intrinsically prostatic have been observed. Some proved to be extensions from cancers of nearby structures such as the periurethral glandules, urethra, urinary bladder, seminal vesicles etc. It is important to be aware of these malignancies since their natural history and response to therapy differs from the usual prostatic cancer. The case presented here shows yet another pattern which is interesting and which may be the first of its kind to be reported. The patient was a normal genotypical, phenotypical man whose prostate was removed for what was thought to be “benign hypertrophy;” however, it revealed a malignancy which was of the endometrial variety and apparently arose from the region of the utricle; in other words, a carcinoma of the uterus masculinus.

Description d'un kyste liquidien de la prostate chez un homme de 56 ans avec presence d'un residu postmictionnel de 70 ml, confirme par l'examen clinique et urographique. Le diagnostic du kyste de l'utricule est fait par ponction du kyste sous anesthesie locale, guidee par echographie. La ponction ramene 23 ml de liquide et quelques leucocytes. Absence de recidive clinique et echographique 3 ans apres