Persistent Müllerian duct structures presenting as hematuria in an adult: Case report of robotic surgical removal and review of the literature

L I Smith-Harrison, Mehul S Patel, Ryan P Smith, Noah S Schenkman
Urology Annals 2015, 7 (4): 544-6
Persistent Müllerian duct syndrome is a rare genetic disorder characterized by a male with retained Müllerian structures. Remnant excision must be considered due to the possibility of malignant degeneration. We review a case of delayed diagnosis in a 25-year-old man presenting with hematuria. Preoperative counseling must emphasize the risk of malignancy versus the risks to fertility. The da Vinci robot offers a novel, safe approach for excision of the relevant Müllerian structures. Dissection should be limited to structures superior to the cavernosal neurovascular bundles to preserve the continence and erectile function. A semen analysis is recommended preoperatively to determine effects on fertility.

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