Laparoscopic management of müllerian duct cysts in infants

Aminsharifi, Alireza; Afsar, Firoozeh; Pakbaz, Sara

doi:10.1016/j.jpedsurg.2011.04.008

Cited by 15 publications

(16 citation statements)

References 14 publications

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“…Up to 60% of patients with MDR remain asymptomatic although they can present with lower urinary tract inflammation and obstructive symptoms (including acute urinary retention) or recurrent cystitis, epididymitis, infertility and chronic pelvic or perineal pain. [ 2 7 ] Different open operative techniques are described, and there is agreement that orchidopexy is indicated to preserve spermatogenesis function and prevents testicular malignancy. There is no agreement however on the excision, partial removal or midline splitting of the MDR should be performed.…”

Section: Discussionmentioning

confidence: 99%

“…This avoids injury to the pelvic nerves and thus helps preserve postoperative voiding and bowel function. [ 7 ] This is a huge benefit of laparoscopy as open surgical treatment of MDR in the male patient varies according to the size of the utricle, and a double approach often is necessary. [ 3 ] The use of laparoscopy in the diagnosis and treatment of PMDS has been reported, and different surgical options and algorithms are suggested for management.…”

Section: Discussionmentioning

confidence: 99%

“…After the first description of a laparoscopic approach for the management of Müllerian duct remnant (MDR) in an adult, in 1994 in the USA, the first laparoscopic treatment of MDR in the paediatric age group was reported in Europe in 1998. [ 7 ] Since then, a few cases have been reported about laparoscopy role in PMDR diagnosis and treatment. This study performed a literature review to determine feasibility and safety of laparoscopic management of MDRs.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic management of Müllerian duct remnants in the paediatric age: Evidence and outcome analysis

Raičević

Saxena

2018

J Min Access Surg

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Background:This study performed a literature analysis to determine outcomes of laparoscopic management in Müllerian duct remnants (MDRs).Patients and Methods:Literature was searched for terms ‘Müllerian’ ‘duct’ ‘remnants’ and ‘laparoscopy'. Primary end points were age at surgery, laparoscopic technique, intraoperative complications and postoperative morbidity.Results:The search revealed 10 articles (2003–2014) and included 23 patients with mean age of 1.5 years (0.5–18) at surgery. All patients were 46XY, n = 1 normal male karyotype with two cell lines. Explorative laparoscopy was performed in n = 2 and surgical management in n = 21. The 5-port technique was used in n = 10, 3-port in n = 9 and robot-assisted laparoscopic approach in n = 1 (n = 1 technique not described). Complete MDRs removal in n = 9, complete dissection and MDRs neck ligation with endoscopic loops in n = 11 and n = 1 uterus and cervix were split in the midline. After MDRs removal, there were n = 2 bilateral orchidopexy, n = 3 unilateral orchidopexy, n = 1 Fowler–Stephens stage-I and n = 1 orchiectomy. Mean operative time was 193 min (120–334), and there were no intraoperative complications. Mean follow-up was 20.5 months (3–54) and morbidity included 1 prostatic diverticula. There were 13 associations with hypospadias, of which 3 had mixed gonads and 3 bilateral cryptorchidism. Other associations were unilateral cryptorchidism and incarcerated inguinal hernia n = 1, right renal agenesis and left hydronephrosis n = 1 and n = 2 with transverse testicular ectopy.Conclusion:This MDRs analysis suggests that the laparoscopic approach is an effective and safe method of treatment as no intraoperative complication has reported, and there is low morbidity in the long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic management of Müllerian duct remnants in the paediatric age: Evidence and outcome analysis

Raičević

Saxena

2018

J Min Access Surg

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“…Utricular cysts are tubular or vesicular in shape, mostly seen in young patients with proximal hypospadias or intersex disorders and they usually communicate with the urethra. Mullerian duct cysts generally do not communicate with the prostatic urethra, are round in shape and present in adults with normal external genitalia [1,4]. The majority of utricular cysts are asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

Prostatic utricle cyst presenting with recurrent urethral discharge in the newborn: A case report

Lazarus¹,

Maison²,

Howlett³

2017

PUCR

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A B S T R A C TA 6 month old boy with normal external genitalia, presented with purulent urethral discharge from the neonatal period and recurrent urinary tract infections. Radiologic and urethrocystoscopic evaluation showed a midline structure connected to the prostatic urethra and discharging with pus. This structure, considered to be a prostatic utricle cyst was successfully drained endoscopically.

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“…3 Other treatment modalities include open cyst resection, transurethral laser incision, laparoscopic resection, robotic assisted laparoscopic resection and transperineal or transrectal cyst aspiration. [3][4][5][6][7] This patient underwent cystoscopy and transurethral unroofing of the symptomatic cyst with a Collins knife, following which a large amount of milky fluid was expressed. No stones or lesions were seen within the cyst.…”

mentioning

confidence: 99%