The Prostatic Utricle in the Fetus and Infant

Abstract

The prostatic utricle (uterus masculinus) has been examined in 194 fetuses and infants, and its appearance before and after birth has been described. The utricle was markedly enlarged in 16 cases and caused extreme bulging of the colliculus seminalis in 5 cases. Obstruction of the prostatic urethra by an enlarged utricle with extreme bulging of the colliculus seminalis must be considered as a possible cause of urinary obstruction in the the newborn infant. Associated changes in the upper urinary tract are probably only encountered in very severe cases of longer duration.

Developmental estrogenization and prostatic neoplasia

“…As a result of unopposed action of maternal estrogens [81,82], metaplastic changes occur in prostates of newborns. Since similar changes have been found in all fetal prostatic tissue [83,84], the hypothesis is raised whether developmental estrogenization may be a general physiological phenomenon in men.…”

“…Although Driscoll and Taylor [84] did not report ductal metaplasia to be a general phenomenon in newborns, these investigators found squamous metaplasia in prostatic ducts of infants exposed in utero to exogenous female sex hormones. Variation in the extensiveness of metaplastic epithelium was reported by Zondek and Zondek [83], but the extent of metaplastic change was not always related to the size of the utricle, which has been used as a marker of androgen insufficiency [87]. The lack of association between the size of the prostatic utricle and the extent of metaplasia in the developing prostate suggests that estrogenization may represent a separate hormonal response which is regulated independently of masculinization.…”

“…During normal fetal development, metaplastic changes begin to appear after approximately 22 weeks of gestation, with the epithelium of the prostatic utricle being the first area to exhibit change [85,86]. Thereafter, metaplastic transformation extends into the epithelium covering the colliculus seminalis, the lower ends of the ejaculatory and prostatic ducts, and some adjacent submucosal glands [83,85,86]. It is unknown whether the metaplastic transformation in epithelial cells is related to the embryonic origin of the cells (i.e., the mullerian or wolf-fian ducts, or the urogenital sinus).…”

The Endocrinology and Developmental Biology of the Prostate*

“…In the adult, estrogen-induced squamous metaplasia is reversible after estrogen withdrawal (8,203,209), whereas estrogen exposure in the perinatal period may lead to a state of permanent irreversible squamous metaplasia (214)(215)(216)(217). In human fetuses, squamous metaplasia occurs spontaneously in the developing prostate beginning at about 22 weeks of gestation, presumably due to high levels of maternal estrogens (54, 203,[218][219][220][221][222][223]. The incidence of squamous metaplasia is elevated in prostates of human infants and stillborns whose mothers ingested diethylstilbestrol (DES) during pregnancy (224).…”

Hipospadiyas ve İnterseks Olgularında Prostatik Utrikül Konfigürasyonu Prostatic Utricle Configuration in Hypospadias and Intersex Patients

“…PU büyü-mesini açıklamak için prostatik utrikül obstrüksiyonu, intrauterin androjen yetersizliği ve intrauterin müllerian inhibe edici faktör (MIF) yetersizliği gibi varsayım-lar öne sürülmüştür (2). PU'lerin çoğu asemptomatik olmasına karşın tekrarlayan idrar yolu enfeksiyonu (İYE), taş oluşumu, üriner obstrüksiyon, hematüri, enürezis ve tekrarlayan epididimite neden olabilir.…”