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Enlarged prostatic utricle and vagina masculinus in boys with disorders of sex development

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Abstract

Purpose

To determine the prevalence, radiological characteristics, and clinical symptomatology of enlarged prostatic utricles and vagina masculinus in boys with disorders of sex development.

Methods

Over 10 years (from February 2012 to March 2022), 102 boys with severe hypospadias underwent voiding cystourethrography. All patients presented with disorders of sex development and Y material in the karyotype (46,XY karyotype, 46,XY/45,X mosaic, etc.). The age of the patients at the first examination ranged from 4 days to 27 months (mean age 2.7 months).

Results

Voiding cystourethrography revealed the presence of a cyst posterior to the urethra in 66 patients (64.7% of cases). There were 15 cases of “vagina masculinus” and 51 of enlarged prostatic utricles. These dilations were classified according to the Ikoma classification and cyst size. In more than 2/3 of cases, the cysts were small (less than 20 mm), and in less than 8% of cases, these cysts were large. In addition, retrograde opacification revealed the presence of vesicoureteral reflux in 20% of boys with a male vagina. The most severe hypospadias with a scrotal or perineal meatus are most at risk of developing an enlarged prostatic utricle, and 80% of patients with Ikoma Grade III had a scrotal or perineal meatus.

Conclusion

This study shows that the prevalence of enlarged prostatic utricles and vagina masculinus is high in patients with severe hypospadias. Therefore, their search should be systematic, and for clinical and therapeutic interest, the enlarged prostatic utricles should be classified according to cyst size.

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Authors and Affiliations

  1. Department of Visceral Surgery, Faculty of Medicine, Children’s Hospital Canastel, University of Oran, Oran, Algeria

    Smail Acimi, Naima Abderrahmane & Lamia Debbous

  2. Department of Endocrinology, Faculty of Medicine, CHU of Oran, University of Oran, Oran, Algeria

    Nadjia Benabadji

  3. Department of Urology, Faculty of Medicine, EHU of Oran, University of Oran, Oran, Algeria

    Mohammed Ali Acimi

Authors
  1. Smail Acimi
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  2. Naima Abderrahmane
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  3. Lamia Debbous
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  4. Nadjia Benabadji
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  5. Mohammed Ali Acimi
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Contributions

SA, NB and NA contributed to the design and implementation of the research, SA, NA, LD, MAA to the analysis of the results and to the writing of the manuscript. SA conceived the original and supervised the project.

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Correspondence to Smail Acimi.

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The authors declare that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Acimi, S., Abderrahmane, N., Debbous, L. et al. Enlarged prostatic utricle and vagina masculinus in boys with disorders of sex development. World J Urol 41, 595–600 (2023). https://doi.org/10.1007/s00345-022-04273-z

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  • DOI: https://doi.org/10.1007/s00345-022-04273-z

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