Abstract：
Background: A prostatic utricle (PU) is an unusual pathology with most patients being asymptomatic. However, approximately 29% of patients may show lower urinary tract symptoms, recurrent urinary tract infections (UTI), postvoid dribbling, urethral discharge, epididymo-orchitis, stones, and secondary incontinence caused by urine trapping in the pouch and urinary retention. The standard treatment is through surgical resection, but it is only offered to patients with symptoms. Case summary: We report a case involving a six-year-old boy with congenital hypothyroidism and penoscrotal hypospadias who had previously undergone onlay urethroplasty for the proximal shaft, chordee release, orchidopexy for bilateral undescended testis, and laparoscopic herniorrhaphy for left inguinal hernia. However, the patient later evolved the repetition of UTI and right epididymo-orchitis. Cyclic voiding cystourethrography confirmed the presence of a cystic lesion communicating with the prostatic urethra from the utricle. The PU was then excised laparoscopically. The utricle was identified posterior to the bladder, and insertions of the vas deferens crossover into the utricle were detected by laparoscopy. The post-procedure course was uneventful. Conclusions: Laparoscopic resection of PUs offers a better exposure field, improved wound appearance, complete resection, and reduces the incidence of complications. During laparoscopy, the PU was clearly distinguished from the bladder or other pelvic organs. An incidental finding of vas deferens crossover has rarely been reported. A combined cystoscopy and laparoscopy for PU resection is executable, safe, and valid in this patient population.
摘要：
背景：前列腺囊（PU）是一种不寻常的病理，大多数患者无症状。然而,大约29%的患者可能会出现下尿路症状，复发性尿路感染（UTI），后运球，尿道分泌物,附睾-睾丸炎,石头,以及由小袋内尿液滞留和尿潴留引起的继发性尿失禁。标准的治疗方法是手术切除,但它只提供给有症状的患者。病例总结：我们报告了一例6岁男孩患有先天性甲状腺功能减退症和阴囊尿道下裂的病例，该男孩以前曾接受过近端尿道成形术，合唱释放，双侧未降睾丸的睾丸固定术，腹腔镜疝修补术治疗左腹股沟疝。然而,患者后来发展为UTI和右侧附睾-睾丸炎的重复。循环排尿膀胱尿道造影证实存在囊性病变，该囊性病变与前列腺尿道连通。然后通过腹腔镜切除PU。在膀胱后方发现了动脉囊,通过腹腔镜检查发现输精管交叉插入到动脉中。手术后的课程很顺利。结论：腹腔镜下PU切除术提供了更好的暴露范围，改善伤口外观，完全切除,减少并发症的发生。在腹腔镜检查期间，PU与膀胱或其他盆腔器官明显不同。很少有偶然发现输精管交叉的报道。膀胱镜检查和腹腔镜联合切除PU是可行的，安全,并且在这个患者群体中有效。
