Robotic removal of Müllerian duct remnants in pediatric patients: our experience and a review of the literature

Pediatr Med Chir. 2018 May 30;40(1). doi: 10.4081/pmc.2018.182.

Abstract

Persistent Müllerian duct syndrome is a disorder of sexual development, which features a failure of involution of Müllerian structures. An enlarged prostatic utricle is a kind of Müllerian duct remnant (MDR) with a tubular shaped structure communicating with the prostatic urethra. Treatment is aimed at relieving symptoms when present, preserve fertility and prevent neoplastic degeneration. We describe 3 cases of successful robot assisted-removal of symptomatic MDRs. The first case came to our attention for pseudo-incontinence; the other two for recurrent urinary tract infections. The patients have not presented such symptoms anymore on follow-up. We then reviewed existent literature on authors who have recently investigated the main issues concerning MDRs and have attempted a roboticassisted approach on them. Robot-assisted laparoscopy can be considered a valid, safe and effective minimally-invasive technique for the primary treatment of prostatic utricle.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Disorder of Sex Development, 46,XY / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Mullerian Ducts / surgery
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • Urinary Incontinence / etiology
  • Urinary Tract Infections / etiology

Supplementary concepts

  • Persistent Mullerian duct syndrome