Parameatal urethral cysts are rare benign lesions first reported in 1956 by Lantin and Thompson. To date, only about 50 cases have been documented in the world literature. The exact etiology and development of these cysts remain uncertain. While they often grow asymptomatically, some patients may experience urinary issues such as retention and dysuria. In this article, we present a case study of a 15-year-old boy with a parameatal urethral cyst, discussing its presentation, diagnosis, and management.

A 15-year-old boy, without any major systemic diseases, was brought to our clinic due to a cystic mass on the glans penis present since birth. The lesion was painless but caused disturbances in urinary flow, mild sensations of urinary obstruction, and raised cosmetic concerns. Physical examination revealed a soft, non-tender, translucent cystic mass on the right lateroventral side of his urethral orifice, approximately 7mm in diameter. Ultrasound revealed a simple cyst measuring 5mm by 5mm, without obvious increase in Doppler signal. Surgical excision was performed, ensuring complete removal of the cyst lining, resulting in acceptable cosmetic outcomes and the resolution of urinary symptoms. Histopathology revealed a squamous mucosa with a submucosal cystic lesion lined with stratified columnar epithelium, consistent with a parameatal urethral cyst.

The etiology of parameatal urethral cysts is uncertain, with theories suggesting defective foreskin delamination or paraurethral duct occlusion. They commonly appear on the lateroventral urethral meatus and are usually <1cm in children. Symptoms, when present, include urinary obstruction, pain, or aesthetic issues, though many cases are asymptomatic. Histologically, they are categorized as urethral, epidermal, or mixed types. Differential diagnoses like fibroepithelial polyps or dermoid cysts require imaging or biopsy for distinction. Management varies from observation for asymptomatic cases to surgical excision for symptomatic ones. Complete removal of the cyst lining is critical to prevent recurrence and optimize outcomes. Post-surgical recurrence is rare.

Though rare, parameatal urethral cysts can impact urinary function and aesthetics. This case shows that surgical excision effectively resolves symptoms and improves appearance. Clinician awareness is vital for prompt diagnosis. Further research is needed to better comprehend its underlying causes and optimize treatment approaches.