陰莖正中縫囊腫性交後膿瘍化- 案例報告
張廷瑞、陳世亮、許智凱
台南市立醫院 泌尿科
Abscess Change of Median Raphae Cyst after Sexual Intercourse in a Middle-aged Man
Ting-Jui Chang, Shih-Liang Chen, Chih-Kai Hsu
Divisions of Urology, Tainan Municipal Hospital, Tainan, Taiwan
Background: Median raphe cysts are benign lesions that present anywhere between the urethral meatus to the anus, along midline of the ventral side. Discover commonly during childhood or adolescents. It is usually asymptomatic or unrecognized during childhood. The cysts become symptomatic with advancing age due to infection or trauma. Here we present the case of middle age man, who presented abscess change of median raphe cysts after sexual intercourse.
Case Report: A 43 year old male patient came to our OPD with the complaint of 2 x 2cm protruding mass noted along the urethra meatus. A small cystic lesion was presented since several years ago without symptomatic and or increasing in size. Until, a month ago, after having sexual intercourse, he noted the cyst grew it’s size gradually with color change and pain. Aspiration of the cystic mass with excision was done at OR. Pathologic report revealed a median raphae cyst with abscess change.
Discussion: Median raphe cysts are uncommon benign congenital lesions that can develop at any site along the midline of the ventral side of the male genital area, from the urethral meatus to the anus and the perineum. The most common location is the penile shaft and the parameatal position. They have been rarely reported in the glans of penis and the scrotum. Most of the them, are asymptomatic or unrecognised during childhood, may progress slowly and become symptomatic during adolescence or adulthood. The more distal the location, the bigger the size, greater will be the manifestation of the symptoms, such as pain (may be due to infection or trauma), urinary difficulty, hematuria, hematospermia and difficulty in having sexual intercourse. According to the histopathological findings, median raphe cysts can be classified into four types: urethral (55%), epidermoid (5%), glandular (3%) and mixed (36%). Treatment should be considered for the symptomatic lesions and for cosmetic purposes. Aspiration alone did not recommend due to high recurrence rate. Excision followed by primary closure, remains the optimal treatment option.