Abstract：
The prostatic utricle (PU) consists of the caudal remnant of the Müllerian duct and the urogenital sinus. The term \"vagina masculina\" is used if other Müllerian structures are associated with the PU. This work aims to investigate the incidence, management, and follow up of enlarged PUs and Müllerian remnants in males with posterior hypospadias.
This study presents a retrospective review of cases presented with posterior hypospadias over a 5-year period. Prior to hypospadias repair, retrograde urethrograms were used to investigate enlarged PU. Subsequently, they were classified according to the Ikoma score and further assessed by karyotyping and cystoscope. Surgical excision was indicated in cases with symptomatic utricles or vagina masculina.
Thirty patients were included in the study in the period between 2015 and 2020 (Table). All cases were asymptomatic initially. Twelve patients were diagnosed with enlarged PU; three of them had vagina masculina. One case with perineal hypospadias had a separate perineal opening for PU. Following hypospadias repair, three of the eight cases treated conservatively turned symptomatic.
The incidence of enlarged PU and Müllerian remnants varied among different studies. However, it increased as the severity of hypospadias increased. Preoperative urethrogram was helpful in the diagnosis and classification of PU, but it had its limitations. Cystoscope was more advantageous in diagnosing vagina masculina. Although most cases were asymptomatic, some turned symptomatic after hypospadias repair. Some cases with perineal hypospadias had PU with a separate perineal opening.
The incidence of enlarged PUs or Müllerian remnants was 40%. Although cases were asymptomatic before hypospadias surgery, some cases turned into symptomatic after hypospadias repair. In some cases, the PU or Müllerian remnants had a separate perineal opening. They can be classified as a particular form of Ikoma grade III necessitating surgical intervention.
This study presents a retrospective review of cases presented with posterior hypospadias over a 5-year period. Prior to hypospadias repair, retrograde urethrograms were used to investigate enlarged PU. Subsequently, they were classified according to the Ikoma score and further assessed by karyotyping and cystoscope. Surgical excision was indicated in cases with symptomatic utricles or vagina masculina.
Thirty patients were included in the study in the period between 2015 and 2020 (Table). All cases were asymptomatic initially. Twelve patients were diagnosed with enlarged PU; three of them had vagina masculina. One case with perineal hypospadias had a separate perineal opening for PU. Following hypospadias repair, three of the eight cases treated conservatively turned symptomatic.
The incidence of enlarged PU and Müllerian remnants varied among different studies. However, it increased as the severity of hypospadias increased. Preoperative urethrogram was helpful in the diagnosis and classification of PU, but it had its limitations. Cystoscope was more advantageous in diagnosing vagina masculina. Although most cases were asymptomatic, some turned symptomatic after hypospadias repair. Some cases with perineal hypospadias had PU with a separate perineal opening.
The incidence of enlarged PUs or Müllerian remnants was 40%. Although cases were asymptomatic before hypospadias surgery, some cases turned into symptomatic after hypospadias repair. In some cases, the PU or Müllerian remnants had a separate perineal opening. They can be classified as a particular form of Ikoma grade III necessitating surgical intervention.
摘要：
背景：前列腺囊（PU）由苗勒管和泌尿生殖窦的尾部残余组成。如果其他苗勒式结构与PU相关联，则使用术语“阴道男性”。这项工作旨在调查发病率，管理,并对患有后尿道下裂的男性的扩大的PU和Mülerian残留物进行随访。
方法：本研究对5年后尿道下裂病例进行回顾性分析。尿道下裂修复前,逆行尿道造影用于调查扩大的PU。随后，根据Ikoma评分进行分类,并通过核型分析和膀胱镜检查进行进一步评估.在有症状的子宫或阴道阳性的情况下，应进行手术切除。
结果：在2015年至2020年期间，30名患者被纳入研究（表）。所有病例最初无症状。12例患者被诊断为PU增大；其中三个有阴道男性。1例会阴尿道下裂有单独的会阴开口用于PU。尿道下裂修复后,保守治疗的8例病例中有3例出现症状.
结论：在不同的研究中，增大的PU和Mülerian残余物的发生率不同。然而,它随着尿道下裂严重程度的增加而增加。术前尿道造影有助于PU的诊断和分类，但它有其局限性。膀胱镜对诊断男性阴道更有优势。尽管大多数病例无症状，一些尿道下裂修复后出现症状。一些会阴尿道下裂患者的PU带有单独的会阴开口。
结论：增大的PU或Müllerian残余物的发生率为40％。尽管病例在尿道下裂手术前无症状，一些病例在尿道下裂修复后出现症状。在某些情况下,PU或穆勒遗迹有一个单独的会阴开口。它们可以归类为需要手术干预的IkomaIII级的特定形式。
方法：本研究对5年后尿道下裂病例进行回顾性分析。尿道下裂修复前,逆行尿道造影用于调查扩大的PU。随后，根据Ikoma评分进行分类,并通过核型分析和膀胱镜检查进行进一步评估.在有症状的子宫或阴道阳性的情况下，应进行手术切除。
结果：在2015年至2020年期间，30名患者被纳入研究（表）。所有病例最初无症状。12例患者被诊断为PU增大；其中三个有阴道男性。1例会阴尿道下裂有单独的会阴开口用于PU。尿道下裂修复后,保守治疗的8例病例中有3例出现症状.
结论：在不同的研究中，增大的PU和Mülerian残余物的发生率不同。然而,它随着尿道下裂严重程度的增加而增加。术前尿道造影有助于PU的诊断和分类，但它有其局限性。膀胱镜对诊断男性阴道更有优势。尽管大多数病例无症状，一些尿道下裂修复后出现症状。一些会阴尿道下裂患者的PU带有单独的会阴开口。
结论：增大的PU或Müllerian残余物的发生率为40％。尽管病例在尿道下裂手术前无症状，一些病例在尿道下裂修复后出现症状。在某些情况下,PU或穆勒遗迹有一个单独的会阴开口。它们可以归类为需要手术干预的IkomaIII级的特定形式。
