Prostate cysts
Literature: (Galosi et al, 2009).
Etiology of Prostate Cysts
Utricle cyst:
A utricle cyst (or Müllerian duct cyst) presents with a midline cyst of the prostate and has its origin from the utricle. Histologically, a high PSA expression is typical. Squamous epithelium is not typical for a utricle cyst.
Persisting Müllerian Duct Syndrome:
In disorders of sex development, large (often cystic) pelvic masses may cause symptoms. The cystic structures in persisting Müllerian duct syndrome are, analogous to the vagina, often lined by squamous epithelium and sometimes uterine tissue can be identified (vagina masculina).
Other Causes of Prostatic Cysts:
Cysts derived from seminal vesicles, seminal tract or prostate gland.
Signs and Symptoms of Prostatic Cysts
- Lower urinary tract symptoms due to subvesical obstruction
- Urinary retention
- Urinary tract infection
- Hematospermia
Diagnostic Work-Up
- Transrectal ultrasonography [fig. prostatic cyst in TRUS]
- Abdominal ultrasonography: pelvic masses? Residual urine?
- Urinary flow test
- Cystoscopy
- CT or MRI in disorders of sex development with pelvic masses
 |
Prostatic cyst with subvesical obstruction as seen in transrectal ultrasound See also fig. cystoscopy and treatment of a prostatic cyst of the same patient. |
Differential Diagnosis of Prostatic Cysts
Ectopic ureterocele.
Treatment of Prostatic Cysts
Small symptomatic prostatic cysts can be treated by transurethral resection [fig. transurethral unroofing of a prostatic cyst]. Large pelvic masses of the Müllerian duct system may need open surgery or laparoscopic surgery.
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References
- Galosi, A. B.; Montironi, R.; Fabiani, A.; Lacetera, V.; Gallé, G. & Muzzonigro, G.
- Cystic lesions of the prostate gland: an ultrasound classification with pathological correlation.
J Urol, 2009, 181, 647-657
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