Bladder Outlet Obstruction due to an Unusual Prostatic Midline Cyst in an Adolescent Male

Most prostatic midline cysts, i.e., Müllerian duct cysts or prostatic utricular cysts, probably result from incomplete regression of the Müllerian duct remnant. Congenital cysts may be associated with other urogenital anomalies. Related symptoms include bladder outlet obstruction, hemospermia, ejaculatory-fertility impairment, and recurrent epididymitis. We report an adolescent male who presented with difficulty urinating that lasted for 2 months. After a complete survey with a urodynamic study, ultrasonography, urethrography, urethrocystoscopy, and computed tomography, a prostatic midline cyst with bladder outlet obstruction was identified. Using transurethral cyst unroofing, urination conditions improved according to the International Prostate Symptom Score and a uroflow study. Although there are various surgical interventions for a prostatic midline cyst near the urethra, endoscopic procedures are a safe and elegant alternative compared with other procedures.