Prostatic Cysts

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Prostatic Cysts

The differential diagnosis of prostatic cysts can be approached by first considering whether the cyst is midline or lateral in location. Midline cysts include utricle, mullerian duct, ejaculatory duct, and vas deferens cysts.

Midline Prostatic Cysts

Utricle Cysts

Utricle cysts (Table 117.1) are the most common congenital cysts and are usually diagnosed in childhood due to the association with genitourinary abnormalities such as hypospadias and cryptorchidism. Utricle cysts are due to dilatation of the prostatic utricle, a potential space that drains into the prostatic urethra at the level of the verumontanum.

Mullerian Duct Cysts

Mullerian duct cysts (Table 117.1) arise from remnants of the Mullerian duct. They are typically larger than utricle cysts and extend above the prostate, potentially presenting as a pelvic mass. There is no association with external genitalia abnormalities, although there is a rare association with renal agenesis. If aspirated, neither type of cyst contains sperm. Carcinoma is a rare complication in both types of cysts.