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About Arthur Goldstein, M.D.
Expertise
Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience
I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations
American Medical Association, American Urological Association, American College of Surgeons
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You are here: Experts > Health/Fitness > Urology > Urology > Strange meatus
Expert: Arthur Goldstein, M.D.
Date: 8/15/2008
Subject: Strange meatus
Question
QUESTION: Hi, I am a 22 year old male from Los Angeles, CA. Currently I am on no medication.
Recently I wondered about a strange white/clear bubble like growth directly under the tip of my meatus. I have had this for as long as I can remember, but only recently it dawned on me that it was not a normal part of the anatomy. No fluid is blocked from leaving the meatus. I am unaware of any surgeries as a baby, but perhaps this could be some surgical implant to correct something? I included an image of the meatus for clarification.
http://img225.imageshack.us/img225/6204/jpg134131en7.jpg
Any input is greatly appreciated. Thanks.
ANSWER: Jake, the lesion that you describe and photographed is termed a paraurethral cyst of which there are several types. The most common variety is due to the entrapment of epithelial cells during fusion of the labial-scrotal folds in the fetus. These can be located anywhere from the anus to the inferior aspect of the penile meatus. Since your cyst appears to be situated on the superior aspect of the meatus, it most likely represents another variety of developmental cyst such as an epithelial inclusion cyst, sebaceous cyst or mucoid urethral cyst.
The distinction between the various types of these cysts is academic and can generally only be made by excision and pathologic examination of the tissues. For the most part, these lesions are asymptomatic and do not interfere with urination or sexual activity. They occasionally can become infected and, therefore, it is best not to squeeze them. If a decision is made to treat the cyst either because of recurrent infection or cosmetic reasons, excision is preferred. If simply aspirated, they tend to recur and if merely unroofed, one is left with a shallow crater. Good luck.
---------- FOLLOW-UP ----------
QUESTION: Thank you for the answer. Could you explain the symptoms of such an infection and if it is self-corrected or requires medication? Thank you.
Answer
Jake, these cysts rarely become infected unless they are squeezed. The typical signs of infection are inflammation (redness) of the cyst and surrounding tissue & local discomfort. Since the cyst is located at the meatus of the penis, if swelling is significant, it might affect urine flow. Sometimes with infection, the pressure of pus inside the cyst increases which can rupture the cyst wall with resultant drainage of purulent material. If the cyst drains spontaneously, the problem can usually be cured by applying warm wet compresses to the area until resolution of the inflammation. Systemic antibiotics are not generally needed unless one has associated fever (a rare occurrence). If the process does not resolve or drain on its own, drainage in the office can usually be easily accomplished. If infections are recurrent, excision of the cyst should be considered once the infection has completely resolved.
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