Case reports in urology
Spontaneous Pregnancy After Surgical Correction of a Prostatic Utricle Cyst and Recurrent Varicocele: A Case Report
By Ribeiro CBH, Ortiz LFL, Rezende JR and 3 others.
Abstract
Background
Prostatic utricle cysts are rare congenital anomalies arising from incomplete regression of the Müllerian ducts that may cause partial or complete ejaculatory duct obstruction, leading to hypospermia, abnormal semen parameters and even azoospermia in severe cases. Recurrent varicocele after previous surgical repair represents an additional challenge in the management of male infertility. Here, we report a case of spontaneous pregnancy achieved after combined surgical correction of a prostatic utricle cyst and recurrent left-sided varicocele in a couple not yet meeting the formal 12-month criteria for infertility, illustrating the diagnostic and therapeutic considerations relevant to this clinical scenario.
Case presentation
A 27-year-old man with a history of bilateral microsurgical varicocelectomy in 2018, persistent hypospermia (ejaculate volume 0.1-0.5 mL), reduced sperm motility (8%-24% progressive motility) and abnormal strict Kruger morphology (1%-3%) was evaluated together with his 35-year-old partner after 6 months of attempting natural conception. Scrotal Doppler ultrasonography confirmed recurrent left-sided varicocele, and pelvic magnetic resonance imaging revealed a prostatic utricle cyst measuring 1.6 × 1.0 cm. The female partner had no relevant abnormalities on complete gynaecological evaluation. The male partner underwent transurethral resection of the prostatic utricle cyst combined with subinguinal microsurgical redo varicocelectomy in a single surgical session without complications. Two months postoperatively, spontaneous clinical pregnancy was confirmed, and two semen analyses performed 4 months after surgery showed normalisation of all seminal parameters.