Newer insights into prostatic utricle in proximal hypospadias

• Main Authors: Mamta Sengar (Author), Niyaz Ahmed Khan (Author), Yousuf Siddiqui (Author), Anup Mohta (Author), Alisha Gupta (Author), Chhabi Ranu Gupta (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2022-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0971-9261; 1998-3891; 10.4103/jiaps.jiaps_96_21
• Keywords: cystoscopy; hypospadias; prostatic utricle; voiding cystourethrogram; Pediatrics; RJ1-570; Surgery; RD1-811
• Source: Journal of Indian Association of Pediatric Surgeons, Vol 27, Iss 4, Pp 387-390 (2022)

Introduction: Prostatic utricles (PUs) are the remnants of Mullerian ducts found in the male posterior urethra. Enlarged symptomatic utricles are known to be associated with hypospadias. There is a dearth of literature defining an enlarged utricle and also its clinical significance. Aims: The aim of this study was to describe anatomical difference of PUs of cases with severe hypospadias and also to find their clinical significance if any. Materials and Methods: A prospective study was carried out, and all patients with proximal hypospadias were enrolled. Cystoscopy was performed in all cases. Symptomatology, size, and location of PU were recorded. PU of >0.5 cm was considered enlarged. Results: In the present series, a total of 70 cases were included over a period of 2 years. Enlarged utricle was found in 47/70 (67.14%) on cystoscopy. They were wide-mouthed and negotiated 9 Fr/11 Fr cystoscope with ease. Recurrent epididymo-orchitis, recurrent urinary tract infection, and obstructive features were the most common complications requiring intervention. Conclusions: PUs in boys with hypospadias are enlarged as well as wide-mouthed. Most of these remain asymptomatic, but few of them carry the potential of complications. Cystoscopy helps in direct visualization of utricular anatomy, so it should be a preferred investigating modality for investigating a PU.