Hemospermia Owing to Utricular Cyst: Embryological Summary and Surgical Review

Poppel, Hendrik Van; Vereecken, R.L.; Geeter, Patrick de; Verduyn, H

doi:10.1016/s0022-5347(17)52257-0

Cited by 81 publications

(34 citation statements)

References 7 publications

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“…Many other investigators do not agree with this opinion [6]. From the clinical point of view, the differentiation between these two types of cysts has no significance as both are managed in the same way.…”

Section: Discussionmentioning

confidence: 96%

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

Barzilai

Ginesin

1998

Urol Int

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The unique appearance of a midline prostatic cyst is reported. The cyst presented as a round-shaped filling defect at the base of the urinary bladder during an intravenous pyelography study. Transabdominal sonography showed the mass to be a midline prostatic cyst. The sonographic features of the mass and its location are the hallmark of a müllerian duct prostatic cyst. Midline prostatic cysts are discussed and the features differentiating müllerian duct cysts from utricle cysts are emphasized.

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Section: Discussionmentioning

confidence: 96%

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

Barzilai

Ginesin

1998

Urol Int

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“…The mullerian duct cyst is of mesodermal origin, not communicating with the prostatic urethra or seminal vesicles, and it never contains sperm. In the utricular cyst, which is of endodermal origin, the ejaculatory ducts can be localized in the lateral wall of the cyst, communication with the prostatic urethra is common and sperm may be present (2,3). Histologically there is no evidence of cytologic atypia, and columnar epithelium can be seen, indicating prostatic origin.…”

Section: Discussionmentioning

confidence: 99%

Infravesical Obstruction Due to Benign Intraurethral Prostatic Cyst

et al. 2003

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INTRODUCTIONThe prevalence of prostatic cysts detected by transrectal ultrasound is 5% (1). Most prostatic cysts are asymptomatic and are located in the medial portion of the prostate. Midline cysts are located posteriorly at the prostatic floor, originating from posterior structures such as the utricle, the ejaculatory duct, or an intraprostatic ectopic ureter. We report a patient with a unique intraurethral prostatic cyst that originated from the left side of the lateral lobe of the prostate (2 o' clock direction) and discuss the clinical presentation, transrectal ultrasonographic/cystoscopic features, and management. To our knowledge, this is the second documentation of such an entity in published reports. CASE REPORTA healthy 42-yr-old man presented with a 10-yr history of progressive, infravesical obstructive symptoms that did not respond to medical therapy such as alpha-blocker. The International Prostate Symptom Score (IPSS) was 18, and the quality of life (QOL) score was 5. Digital rectal examination revealed a minimally enlarged prostate without palpable nodules. Uroflowmetry showed a peak flow rate (Qmax) of 7 mL/sec (200 mL voided volume) and a postvoid residual urine volume of 150 mL. The cyst (20×15 mm) was anechoic and appeared to be obstructing the bladder neck on the transrectal ultrasonography (Fig. 1A) A large, fluid-filled cyst with a smooth surface was located at the bladder neck on cystoscopy (Fig. 1B). The cystic lesion had a single short stalk that originated from the left lateral lobe of the prostate. The cyst appeared to be obstructing the bladder outlet by a ball-valve action. There was no lateral lobe prostatic hypertrophy. The bladder was moderately trabeculated. Both ureteral orifices were normal and distant from the cyst. The prostate measured 35 mL. Transurethral resection of the cyst at base of the cyst was performed. The histopathologic findings were consistent with a benign cyst lined with columnar epithelium and proliferative urothelial lining (Fig. 2). We performed a follow-up check at 3 months after surgery. Postoperatively, Qmax increased to 15 mL/sec without residual urine. There was neither erectile dysfunction nor retrograde ejaculation. DISCUSSIONProstatic cysts are common, with a 5% incidence in a male population (1).A cyst in the midline of the prostate gland is a mullerian duct cyst or a utricular cyst. These terms tend to be used interchangeably but recent studies suggest different embryological origins. The mullerian duct cyst is of mesodermal origin, not communicating with the prostatic urethra or seminal vesicles, and it never contains sperm. In the utricular cyst, which is of endodermal origin, the ejaculatory ducts can be localized in the lateral wall of the cyst, communication with the prostatic urethra is common and sperm may be present (2, 3). J Korean Med Sci 2003; 18: 125-6 ISSN 1011-8934 Copyright � The Korean Academy of Medical Sciences 125 Infravesical Obstruction Due to Benign Intraurethral Prostatic CystWe report a case of symptomatic intraurethra...

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“…Van Poppel et al first reported a 31-year-old man with persistent hematospermia associated with a 3 cm midline cyst. 21 Transrectal aspiration of the mass yielded 3 mL of dark brown fluid which contained many red blood cells but no spermatozoa. Neustein et al reported a 28-year-old man with chronic hematospermia due to a müllerian duct cyst, diagnosed by MRI.…”

Section: Discussionmentioning

confidence: 99%

Hematospermia: An investigation of the bleeding site and underlying lesions

Furuya

Ogura²,

Saitoh³

et al. 1999

Int J of Urology

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Background: The site of hemorrhage and causative lesions in patients with hematospermia were evaluated using the puncture technique for seminal vesicles and/or müllerian duct cysts under ultrasound guidance. Methods: Twenty-one patients aged 26-75 years (mean, 49.8 years) underwent transperineal needle aspiration of the seminal vesicles and/or müllerian duct cysts guided by transrectal ultrasonography (TRUS).Results: Dark reddish seminal vesicle fluid was aspirated and the site of bleeding was considered to be the seminal vesicles in 11 patients (52%) (group A). In group A, abnormalities of the seminal vesicles were noted in nine patients (82%). These consisted of dilated seminal vesicles in seven (bilateral in four, unilateral in three), a seminal vesicle cyst in one and seminal vesicle amyloidosis in one. A müllerian duct cyst was confirmed to be the bleeding site in two patients (10%; group B). The bleeding site was estimated to be organs rather than the seminal vesicles in four patients (group C), in all of whom ectopic prostatic tissue was observed in the prostatic urethra. In groups B and C, seminal vesicle abnormalities were not detected by TRUS. In the remaining four patients (group D), failure to aspirate seminal vesicle fluid means that it is unclear whether hemorrhage was from the seminal vesicle or from another source. In group D, ectopic prostatic tissue was demonstrated in the prostatic urethra of three patients and unilateral seminal vesicle dilation was detected by TRUS in one patient. Conclusion: Puncture of the seminal vesicles and/or müllerian duct cysts under ultrasonic guidance as well as cystourethroscopy is a useful and minimally invasive examination for determination of the bleeding site responsible for hematospermia.

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Hemospermia Owing to Utricular Cyst: Embryological Summary and Surgical Review

Cited by 81 publications

References 7 publications

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

Infravesical Obstruction Due to Benign Intraurethral Prostatic Cyst

Hematospermia: An investigation of the bleeding site and underlying lesions

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