Parameatal Urethral Cyst

A 4-year-old boy was brought for evaluation of a tiny cystic mass on the penis. The lesion was first noted a year earlier when the foreskin became retractable. At that time, the child was asymptomatic and the family did not seek medical attention. There was no history of urethral discharge or meatal ulceration. Urination was normal. Past health was unremarkable.

The cystic lesion was located at the 3 o'clock position on the glans penis near the urethral meatus and measured 2 mm in diameter. It was nontender. The cyst was excised. Histological examination showed that the cyst was lined by columnar epithelium. The postoperative course was uneventful. The patient was followed up for 2 years with no recurrence of the lesion.

The cause of parameatal urethral cysts is unclear. Congenital lesions are believed to be caused by faulty separation of the foreskin from the glans or occlusion of the parameatal duct. Acquired cysts may result from an infection.

The cysts are usually asymptomatic, although they can be itchy or painful. Large cysts and those in close proximity to the urethral meatus may cause deflection and spraying of the urinary stream.

Treatment consists of complete excision of the cyst. The lesion often recurs after spontaneous rupture or aspiration.

FOR MORE INFORMATION:
• Koga S, Arakaki Y, Matsuoka M, Ohyama C. Parameatal urethral cysts of the glans penis. Br J Urol. 1990;65:101-103.
• Onaran M, Tan MO, Camtosun A, et al. Parameatal cyst of urethra: a rare congenital anomaly. Int Urol Nephrol. 2006;38:273-274.
• Yoshida K, Nakame Y, Negishi T. Parameatal urethral cysts. Urology. 1985;26: 490-491.