Urethral Cysts: Risks, Surgery, and What to Expect

Urethral meatus cyst

Hello, Dr.
Pan.
I have had a small protrusion (approximately 0.6 cm by 0.3 cm) at the junction of the urethral meatus and the frenulum since childhood.
When I press it with my finger, a substance that appears to be liquid disappears, but it returns to its protruded state once I release it.
Over the years, this protrusion has grown to about 0.6 cm by 0.6 cm.
There is no pain during intercourse, and it does not affect urination (though I do experience some dribbling).
Since it affects my appearance, I recently consulted a urologist who diagnosed it as a urethral cyst.
He mentioned that it can be surgically removed or left as is, with no significant difference.
I would like to ask the doctor: what are the risks of surgery? Will the sutures affect the appearance or function? Are there any other considerations I should be aware of? I have scheduled the surgery for January 9th (next Tuesday), and I would greatly appreciate your prompt response.
Thank you.

alex, 30~39 year old female. Ask Date: 2001/01/04

Dr. Pan Zhenqin reply Urology

It sounds like you have a urethral cyst, or a small blister.
It's a minor procedure performed under local anesthesia, which carries minimal risk unless you have a known allergy to anesthetics.
Additionally, the amount of local anesthetic used is quite small.
The sutures will likely be made of absorbable gut sutures, which will fall out on their own after some time.
You may experience a slight burning sensation at the urethral opening during urination for a few days post-surgery, and there may be increased splitting of the urine stream, but there should be no major issues.
This condition typically improves within about a week.
You can proceed with the surgery with peace of mind!

Reply Date: 2001/01/04

More Info

Urethral cysts, also known as urethral diverticula or cysts, are fluid-filled sacs that can develop in the urethra, the tube that carries urine from the bladder to the outside of the body. In your case, the cyst located at the junction of the urethral meatus and the glans penis is likely benign, especially since it has not caused pain during intercourse or significant urinary issues aside from some dripping.

Understanding Urethral Cysts
1. Nature of the Cyst: Urethral cysts can be congenital (present at birth) or acquired. Congenital cysts arise from developmental anomalies, while acquired cysts may result from trauma, infection, or obstruction. Given your description, it seems likely that your cyst is congenital, as it has been present since childhood.

2. Symptoms: Many individuals with urethral cysts are asymptomatic, as you have experienced. However, some may notice symptoms such as urinary incontinence, difficulty urinating, or recurrent urinary tract infections (UTIs). In your case, the only noticeable symptom is some dripping after urination, which is not uncommon.

Surgical Considerations
1. Surgical Risks: The surgical removal of a urethral cyst is generally considered a minor procedure, but like any surgery, it carries some risks. Potential complications include:
- Infection: As with any surgical procedure, there is a risk of infection at the incision site.

- Bleeding: There may be some bleeding during or after the procedure.

- Scarring: Scarring can occur, which might affect the appearance of the area.

- Urethral Stricture: There is a small risk of developing a stricture (narrowing) of the urethra, which could lead to urinary difficulties in the future.

2. Impact on Appearance and Function: The surgical technique used will determine the extent of any changes to the appearance of the urethra and surrounding tissues. Most surgeons aim to minimize scarring and preserve function. If the cyst is removed carefully, it should not significantly affect the cosmetic appearance or urinary function. However, it is essential to discuss your concerns with your surgeon, who can provide specific insights based on your anatomy and the planned surgical approach.

Post-Operative Care and Considerations
1. Recovery: After surgery, you may experience some swelling and discomfort in the area. Pain management will be provided, and you should follow your surgeon's post-operative care instructions closely.

2. Follow-Up: It is essential to attend follow-up appointments to monitor healing and ensure no complications arise. Your surgeon will likely schedule a follow-up visit to assess the surgical site and address any concerns.

3. Hygiene: Maintaining good hygiene is crucial post-surgery to prevent infection. Follow your surgeon's recommendations regarding bathing and care of the surgical site.

4. Urinary Function: After surgery, you should monitor your urinary function. If you notice any changes, such as increased difficulty urinating or new symptoms, contact your healthcare provider promptly.

Conclusion
In summary, while the decision to undergo surgery for a urethral cyst is ultimately yours, it is generally safe and can improve cosmetic concerns. The risks are minimal, and with proper care, most individuals recover well without significant complications. Ensure you have a thorough discussion with your urologist about your concerns and expectations before the procedure. This will help you feel more comfortable and informed about the process. Good luck with your surgery on January 9th!

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