Diagnosis and treatment of ejaculatory duct cyst: A report of 2 cases and review of the literature

LIN Jian-zhong; SHI Guang-dong; WU Hong-fei; YU Hong-bo; ZHOU He-tong; HU Xin; WANG Hao

doi:10.13263/j.cnki.nja.2018.03.009

Abstract：Objective:To investigate the diagnosis and treatment of ejaculatory duct cyst.Methods:This study included 2 male patients present at the hospital for hemospermia and abnormal sensation in the perineal region in July and August 2014.Both underwent transrectal ultrasonography,routine semen examination,CT,MRI,cystoscopy,and vesiculography before transurethral fenestration of the cysts and pathological examination of the cyst wall specimens.Analyses were made on the clinical presentations,imaging features,pathological characteristics,differential diagnosis and treatment of ejaculatory duct cyst and relevant literature was reviewed.Results:The cyst wall was mainly composed of smooth muscle,the inner wall lined with pseudostratified ciliated columnar epithelia,and with positive expressions of CD10 and Muc6 proteins on immunohistochemical staining,which indicated renal iatrogenic ejaculatory duct cyst.The patients were followed up for 18 and 20 months,respectively.All symptoms disappeared and no recurrence occurred after surgery.Routine semen examination for the two patients showed the semen volumes to be 3.5 and 3.1 ml,sperm concentrations 35 and 32 × 106/ml,grade a sperm 32.0 and 26.0％,grade b sperm 18.0 and 31.0％,and semen liquidation time 30 and 34 minutes,respectively.Conclusion:Pelvic cystic masses can be detected by transrectal ultrasonography,CT and MRI,but definite diagnosis relies on vesiculography,pathological examination and immunohistochemical staining.Transurethral fenestration is safe and effective for the treatment of ejaculation duct cyst.