The prostatic utricle (PU), or prostatic pouch, is a rudimentary structure present in the male prostatic urethra, and is derived from both the müllerian and wolffian ducts. As the PU is of mixed origin, a patient with an enlarged utricle should be carefully examined to ascertain whether it is associated with female internal organs. The clinical presentation, diagnostic evaluation, and a new surgical approach, posterior sagittal rectum retracting, are discussed. A plan for management of PU with proximal hypospadias is suggested.