Parameatal Urethral Cyst in Children.

Sir,

Parameatal urethral cysts are a benign and uncommon occurrence in children. They maybe present from birth or develop with time in childhood. They are usually asymptomatic but can have complaints such as splaying of urinary stream, pain during intercourse or micturition, deviation and spraying of urine, discomfort at the parameatal area.[1]

A 14-year-old boy with parameatal urethral cyst for the last 2 years came to us with complaints of the cyst gradually increasing in size. Except for slight discomfort at parameatal region, he had no other complaints. On examination, a tense cyst was seen on the right wall of meatal opening, at 6–12 O’clock, measuring 1 cm × 1 cm [Figure 1a]. The patient was planned for diagnostic cystoscopy to see the extent of the cyst followed by its complete excision. On cystoscopy, the cyst was extending 1 cm inside the urethral opening with mild urethral congestion along with its whole extent, and normal bladder. The cyst was completely excised and meatoplasty was done [Figure 1b]. Histopathological examination revealed cyst lined by squamous epithelium and lumen lined by transitional epithelium. He is doing well on follow-up and is happy with the cosmesis.

Figure 1

Photographs of case (a) parameatal urethral cyst; (b) after cyst excision and meatoplasty

Parameatal urethral cysts have a tendency for spontaneous resolution in newborn and infants. Hence it is advised to go for conservative management in them with regular follow-up; but in symptomatic and older patients who want cosmesis, complete surgical excision is the treatment of choice.[23]

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