黃烱焜¹、范玉華^1,2、黃志賢^1,2

台北榮民總醫院 泌尿部¹；國立陽明大學醫學院 泌尿學科²；書田泌尿科學研究中心³

 

 Chiung-Kun Huang¹, Yu-Hua Fan^1,2, William J.S. Huang^1,2

Department of Urology, Taipei Veterans General Hospital¹; School of Medicine and Shu-Tien Urological Institute², National Yang-Ming University, Taiwan³

A para-meatal urethral cyst is usually asymptomatic. However, It might present with lower urinary tract symptoms such as frequency, alteration of urinary stream, painful micturition, urine retention or painful intercourse. It can occur at any age and can be congenital or acquired. They are usually small cystic lesions located at lateral margin of urethral meatus averaging about 1 cm in diameter. The cyst wall epithelium may be columnar, squamous, or transitional. The treatment of choice is complete excision with low recurrence rate.

 

A 21-year-old college student denied systemic disease presented with protruding cyst from meatus with       dysuria. The para-meatal cyst was found since childhood and enlarging in size in recent months. He complained glans pain on voiding and irritation sensation when walking and squatting. Clinical examination revealed a non-tender cyst arising from left lip of urethral meatus and around 1.5 cm in diameter. Serial survey was done, and results of complete blood count, metabolic panel, urinalysis and low abdominal sonogram were normal. The cyst was excised completely under general anesthesia and the cut margins were sutured with 3-0 catgut suture. Foley was removed on the same day with smooth urination. The wound healed well and symptoms relieved within seven days with satisfied cosmesis. Pathology reported cyst lined by urothelium.

 

A rare case of para-meatal cyst lined by urothelium. Although the cysts are usually asymptomatic, patient may present for poor cosmesis or lower urinary tract symptoms.  Physical examination is enough to make the diagnosis and complete excision with meatal reconstruction remains the treatment of choice.