Pediatric Surgery, Al Azher University, Cairo, Egypt
Most of urethral cysts arise congenitally from the urethral glands as an embryonic remnants, or after closure of the duct system, urethral glands are normally distributed along the whole length of urethra with a specific given names, which are different in male and female.
KeywordsMullerian duct cystCowper’s syringoceleParaurethral cyst of the Littre’s glandPeriurethral cystParameatal cystMucocaeleMucoid cyst
Along the anatomical course of male urethra many cystic swellings may arise either congenitally or as an acquired lesions; usually after repeated attacks of infection.
The reported congenital cysts of urethra include (from proximal to distal):
Enlarged prostatic utricle
Prostatic utricle cyst
Mullerian duct cyst
Paraurethral cyst of the Littre’s gland
Mucocaele (mucoid cyst)
Urethral diverticulum was discussed before in Chap. 29, but there is nomenclature confusion between urethral cyst and diverticulum, and in many literatures there are many diverticula discussed as cysts and vice versa.
Diverticulum is defined as an outpouching of a hollow (or a fluid-filled) structure, which is not normally present, and covered by all layers of the surrounding tissue. Depending upon which layers of the structure are involved, they are described as being either true or false, which had only single layer covering and without muscle coat.
A cyst is a cavity lined by a distinctly abnormal cell layer (in both appearance and behaviour) when compared to all surrounding cells for that given location.
Most of urethral cysts arise congenitally from the urethral glands as an embryonic remnants, or after closure of the duct system. Urethral glands are normally distributed along the whole length of urethra with a specific given names, which are different in male and female. Male urethral glands are:
Periurethral glands (Littre’s glands):Which branch off the wall of the male urethra and in man these glands secrete mucus and are most numerous in the section of the urethra that runs through the penis. It produces a colloid secretion containing glycosaminoglycans; which thought to protect the epithelium against urine.
Bulbourethral glands (Cowper’s glands): They are two small paired exocrine glands in the urethra of male mammals (except dogs), located dorsal to and on either side of the membranous urethra. The main duct draining Cowper’s glands open below the urogenital diaphragm into the ventral aspect of the bulbous urethra. The bulbourethral glands secretion contributes about 5 % of the ejaculate fluid. Its secretion is a clear and rich in mucoproteins, which help to lubricate the distal urethra and neutralize acidic urine. They are homologous to Bartholin’s glands in females.
Prostatic utricle is a small indentation in the prostatic urethra, at the apex of the urethral crest, on the seminal colliculus (verumontanum), laterally flanked by openings of the ejaculatory ducts. It is also known as the vagina masculina or (in older literature) vesicula prostatica. It is thought that prostatic utricle is an embryonic vestige without any detectable physiological function, but Taylor stated that the contraction of this diverticulum allows semen to pass through easily. Thus, it can be regarded as useful during intercourse and an essential part of the male reproductive system .