[Congenital dilatation of the prostatic utricle. Embryologic review, diagnosis and treatment. Apropos of 2 pseudo-tumoral cases, without hypospadias]. / La dilatation congénitale de l'utricule prostatique. Rappel embryologique, diagnostic et traitement. A propos de deux observations pseudo-tumorales, sans hypospadias.

ABSTRACT

The authors report two pediatric cases of congenitally dilated prostatic utricle. First a newborn with prenatal ultrasound diagnosis of abdomino-pelvic cystic mass and secondly a 4-year-old boy with urinary incontinence and lower abdominal mass. Unilateral renal hypoplasia was noted in both cases, but no hypospadias. The study of embryogenesis and pathogenesis shows that the anomaly happens before the 8th week of pregnancy. When hypospadias is associated, the anomaly develops later and has a hormonal cause. Prostatic utricle is not only an embryologic Müllerian remnant, but comes from the mesodermic and endodermic tissues. The first clinical signs are often urinary signs or an abdominopelvic mass. The prostatic implantation and the median localization of this cystic mass are both revealed by urethrography and ultrasonography. Computed tomography and especially Magnetic Resonance Imaging may be performed. MRI provides a detailed demonstration of the anatomy and a large field of view in all three planes. It helps to plan surgical therapy. The treatment of prostatic utricle may be percutaneous, endoscopic or surgical. The indications are based on the symptoms, but the risk of malignancy must be kept in mind. In our cases, the marked dilatation of the prostatic utricle led to surgical treatment and retrovesical excision was successful.