Asystematic Prostatic Utricle Management

One of the questions here is, uh, how do we manage an asymptomatic prostatic utericle that was detected on imaging, and a prostatic utericle is something that only happens in boys. Um, a utericle is actually an out pouching in a, in, in the prostate, which is a remnant of embryological development. Almost everybody has, every male has a utericle. Sometimes it's just a little divot in the prostate that you see during a cystoscopy, which is when someone looks in the urethra with a telescope, or on X-ray studies that are identifying the anatomy of the urethra and the bladder. Sometimes they can be up to 5 millimeters big. In very rare instances, the utericle can be very large. These are usually associated with anomalies like a very severe hypospadius or some forms of rectal malformation. More often though, it's not a prosthetic utericle that is the concern for children with interectal malformation, but it is a posterior urethral diverticulum, which is um a remnant of the fistula that was left when the doctors divided the fistula and moved the intestinal tract away from the urinary tract. So if they don't shave that intestinal fistula off very close to the urethra, they leave a segment of intestinal tract behind. Now that is lined with intestinal tissue. And the reasons for intervention, just because we see a utericle or a posteriurethral diverticulum on an X-ray study does not mean it needs to be acted upon. The indications for addressing them are if there is symptoms such as urinary dribbling after the child's gone to the bathroom, emptied their bladder, it's because urine's gone into this diverticulum and is now dribbling out afterwards. If they're having repeated infections and sometimes pain with urination because now they might develop a stone or a chronic infection in this utericle. And then very large urethral diverticula because of the amount of intestinal tissue there might pose a risk for um. Cancers developing in that tissue way down the line, 2030 years down the road, so it is certainly something that we would say needs to be watched, but not all utricles or diverticula need to be treated.