Wolffian duct derivative anomalies: technical considerations when encountered during robot-assisted radical prostatectomy.
BACKGROUND
Although malformations of the genitourinary tract are typically identified during childhood, they can remain silent until incidental detection in evaluation and treatment of other pathologies during adulthood. The advent of the minimally invasive era in urologic surgery has given rise to unique challenges in the surgical management of anomalies of the genitourinary tract.


OBJECTIVE
This article reviews the embryology of anomalies of Wolffian duct (WD) derivatives with specific attention to the seminal vesicles, vas deferens, ureter, and kidneys. This is followed by a discussion of the history of the laparoscopic approach to WD derivative anomalies. Finally, we present two cases to describe technical considerations when managing these anomalies when encountered during robotic-assisted radical prostatectomy.


METHODS
The University of Chicago Robotic Laparoscopic Radical Prostatectomy (RLRP) database was reviewed for cases where anomalies of WD derivatives were encountered. We describe how modifications in technique allowed for completion of the procedure without difficulty.


METHODS
None


CONCLUSIONS
Of the 1230 RLRP procedures performed at our institution by three surgeons, only two cases (0.16%) have been noted to have a WD anomaly. These cases were able to be completed without difficulty by making simple modifications in technique.


CONCLUSIONS
Although uncommon, it is important for the urologist to be familiar with the origin and surgical management of WD anomalies, particularly when detected incidentally during surgery. Simple modifications in technique allow for completion of RLRP without difficulty.
Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, Illinois, USA.
Sujeet S
SS
Acharya
Mohan S
MS
Gundeti
Gregory P
GP
Zagaja
Arieh L
AL
Shalhav
Kevin C
KC
Zorn
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000601:surgery; D012371:Robotics; D012669:Seminal Vesicles / Q000002:abnormalities; D014513:Ureter / Q000002:abnormalities; D014649:Vas Deferens / Q000002:abnormalities; D014928:Wolffian Ducts / Q000002:abnormalities*
D017430:Prostate-Specific Antigen