[P-025]

Cystic Benign Prostatic Hyperplasia

¹Regional Training and Research Hospital Urology Service Erzurum
²Mengücek Gazi University Education and Research Hospital Erzincan
³Yildirim Beyazit University Yenimahalle Training and Research Hospital Ankara
⁴Bilecik State Hsospital Bilecik
⁵Kanuni Education and Resarch Hospital Trabzon
⁶Atatürk Universty Medicine Faculty Urology Service Erzurum

INTRODUCTION:
The debated cystic lesions that are common in prostate include mullerian duct cyst, ejaculatory duct cyst, benign prostatichyperplasia cystic degeneration, cysts that involve prostate, cavitary prostatitis and prostatic abscess. They can be categorized into müller’s duct cysts and utricle.
We present a case with a cyst with multiple septas localized in the prostatic area on the bladder bottom detected during tests, and reviewed the literature.

CASE:
A 53-year-old male patient admitted our polyclinics for thamuria, difficulty in urination, and nocturia. The physical examination revealed no pathologies. Rectal palpation indicated prostate grade II and the size was normal. The ordered laboratory tests were normal. The uroflowmetry showed that maximum flow rate: 11ml/s, post voiding residue: 65 cc. The ultrasonography taken under polyclinic conditions demonstrated a cystic appearance in the prostatic area, therefore magnetic resonance of lower abdominal pelvic was performed on the patient. The report results showed areas of lesion of 4.5x4.5 cm with septal and wall contrast in post-contrast series containing multiple hypo-intense septations in T1AG and hyper-intense septations in T2AG on the bladder bottom (Figures 1,2). The appearance was reported to be consistent with cystic adenoma or cystic adenocarcinoma of prostate. The hydaticserology of the cyst was negative. A prostatic biopsy of 12 quadrants was performed, focusing on the lesion. The results of the pathology were consistent with the benign prostatic hyperplasia (BPH). An endoscopy was performed on the patient due to apparent symptoms of prostatism. The cystoscopy revealed hyperplasia of median lobe. The bladder had increased trabekülasyon. The patient was discharged at postoperative day 3 without complications. The results of the pathology were consistent with BPH, therefore an MR was taken (Figure 3) which showed no pathology. The patient still visits the polyclinic for routine checks.
RESULTS
Prostatic cysts may have different appearances (radiologic) and different symptoms of same size. The patient’s symptoms, age, the size of the cyst, one or multiple cysts, the nature of the cyst, and serum PSA values should be considered for the treatment plan. However, studies including a large series of patients are needed to decide on the treatment and follow-up protocols.

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