Tests for prostate cyst

Prostate cysts

WHAT IS A PROSTATE CYST?

Prostate cyst (prostate) is a collective term used to describe fluid formations of the prostate gland of various nature: acquired and congenital. There are several variants of cysts: degenerative, caused by cystic degeneration against the background of benign hyperplasia (occur in people over 50 years old); Mullerian duct cysts (30-40 years old); cysts of the prostate uterus (typical for people aged 10-20 years); ejaculatory duct cysts; retention cysts.

STRUCTURE OF THE PROSTATE

The prostate gland, or prostate, is part of the male reproductive system, an organ weighing up to 40 grams and the largest size up to 4-5 cm. The gland looks like an inverted pyramid surrounding the initial sections of the urethra, 70% consists of glandular tissue and 30 % from the fibromuscular stroma. Three different zones are distinguished in the prostate gland, which are formed separately in embryogenesis: peripheral, central and transitional.

WHAT ARE PROSTATE CYSTS?

The most common degenerative cysts are multiple and located against the background of enlarged prostate lobules in the transition zone. Müllerian duct cysts are located medially in the area of the colliculus seed and tend to spread in the cranial direction. They are most often larger compared to other cysts, have an oval or teardrop shape, and can become malignant. Cysts of the prostate uterus are located in the midline, have a size of 8-10 mm, pear-shaped, often communicate with the urethra. Cysts of the ejaculatory duct occur against the background of its obstruction as a result of inflammation, fibrosis or other causes, they are located along the duct next to the seminal hillock. Stones are often found in the dilated duct. Retention cysts resulting from obstruction of the prostate ducts are removed from the midline, have a size of 1-2 cm.

DIAGNOSIS OF PROSTATE CYSTS

Contrast-enhanced CT, MRI, and Transrectal ultrasound are used to visualize prostate cysts. On CT scan, cysts appear as hypodense masses that do not accumulate contrast. On MRI in T1-WI mode, cysts have a low signal corresponding to fluid (an increase in signal intensity is a sign of infection or hemorrhage), and in T2-WI mode, the signal from cysts is usually increased. transrectal ultrasound can detect a well-defined anechoic or hypoechoic formation filled with contents that transmit ultrasound well. Differential diagnosis is carried out with cavernous prostatitis and prostate abscess, as well as cystic tumors.

WHO SHOULD I CONSULT MRI OF THE PROSTATE?

In some cases, MRI of the prostate leads to ambiguous results: doctors cannot confidently differentiate between a cyst and a tumor. In these cases, a second opinion is useful - consultation of the MRI results with a doctor who purposefully analyzes prostate images and is a specialist in this particular field. A second opinion on MRI of the prostate can be obtained from the National Teleradiology Network - all disputed and unclear cases are analyzed here. Such an MRI consultation with an expert-level doctor will allow you to be confident in the diagnosis and choose the right treatment.

WHAT A PROSTATE CYST LOOKS

Prostatic uterine cyst on MRI (STIR mode on the left, T1-WI with fat suppression on the right). A centrally located mass with smooth edges is visualized, with a typical hyperintense signal on STIR and a hypointense signal on T1 WI. Source: https://radiopaedia.org/cases/prostatic-utricle-cyst-on-mri-1

MRI (T2-WI) in various patients shows small degenerative cysts in the prostate gland in the form of foci of a hyperintense signal. These are benign changes that do not require a biopsy.

SYMPTOMS OF A PROSTATE CYST

In some cases (7-8%), no symptoms occur, in the rest there are signs of urethral obstruction, as well as infection (more often in the case of Mullerian duct and prostate cysts), pain during ejaculation and traces of blood in the semen (in the case of ejaculatory duct cyst). Common symptoms include pelvic pain, rectal pain, urinary problems.

PROSTATE CYSTS TREATMENT

In many cases, there is no need for treatment. If the cyst leads to the appearance of symptoms, it is drained or punctured, followed by the introduction of a sclerosing drug. Surgical treatment is also possible: symptomatic cysts are removed through the urethra, laparoscopically or by open intervention.

Remember that for successful treatment in some cases it is useful to get a second opinion.

Symptoms and treatments for prostate cysts in men

A prostate cyst (or prostate gland) in men is a benign neoplasm, which is a capsule with liquid contents. A pathological cavity in the prostate gland can appear in a man of any age. But more often it is diagnosed in men older than 55 years. This is due not so much to age-related changes as to a violation of the functionality of the prostate - the outflow of fluid is difficult or the secret is formed in excessive quantities.

Help! In 10% of cases, a prostate cyst is a congenital pathology.

The size of the cystic cavity is often small - 1-4 cm, but in medical practice there have been isolated cases when the capsule contained a liter of liquid.

A prostate cyst in men is not accompanied by painful sensations, but causes severe discomfort and various problems. If you suspect a cyst in the prostate, you should see a doctor as soon as possible. This is due to the fact that the formation of such localization is prone to infection. Node suppuration or abscess are complications that pose a great threat not only to health, but also to the life of the patient.

Classification

Doctors distinguish two main types of prostate cysts, which differ in causes:

By the nature of the occurrence of prostate cysts, there are:

Prostate cysts can be single or multiple, infectious or non-infectious, inflammatory or non-inflammatory. Infectious nodes are formed when the prostate gland is damaged by pathological bacteria and microorganisms. In inflammatory cystic tumors, pus accumulates inside them, which is a dangerous condition that requires the attention of a qualified urologist.

A common cause of prostate cysts in men is a chronic form of prostatitis. In this case, the gland produces a large amount of secretion. Under the condition of poor outflow, the occurrence of a cystic tumor is inevitable. Constant stress, low or too high sexual activity, heavy physical exertion (especially with a full bladder), prostate adenoma - all this accelerates the formation of cystic compaction.

Also, a cystic cavity can appear when the excretory ducts are clamped. The ducts can be pinched by a malignant neoplasm, fibrous tissue, and they can also become clogged with stones.

Let's summarize the above. Prostate cysts in men can form as a result of:

• frequent injuries;
• oncological pathologies;
• prostatitis and adenomas;
• too infrequent or too frequent sexual activity;
• infectious diseases;
• benign gland hyperplasia.

Congenital neoplasms in the prostate area appear with improper development of the Müllerian ducts. Such seals are often multiple.

Clinical picture

Symptoms of a prostate cyst in men can be as follows:

All of the above signs are not specific and may vary in intensity depending on the course of the disease and the location of the neoplasm.

Complications and consequences

In the absence of adequate treatment, the prostate cyst will actively grow, which will lead to squeezing of the organs located in close proximity to the gland. Long-term development of a cystic neoplasm can threaten the following complications:

• inability to completely empty the bladder;
• atrophic or necrotic phenomena in the tissues of the prostate gland;
• transformation of a benign formation into a malignant tumor;
• cyst rupture;
• prostate abscess;
• erectile dysfunction;
• infertility;
• prostate cancer.

The most dangerous is the cyst of the vas deferens of the prostate gland. In this case, the risk of inflammation and suppuration increases significantly, the formation compresses the ducts, which leads to tissue necrosis.

Diagnosis

If there are no contraindications for a rectal examination, the doctor palpates the gland through the anus. When determining the nodes, the doctor can already make a preliminary diagnosis. However, this method is effective if the neoplasm is located on the surface of the organ facing the rectum.

To clarify the diagnosis, the following are also used:

• transrectal or transabdominal ultrasound;
• blood test;
• urinalysis;
• spermogram;
• examination of prostate secretions;
• Biopsy if necessary.

Prostate cyst treatment and removal

Treatment of prostate cysts in men is prescribed depending on the stage of the pathological process.If there are no obvious symptoms, the inflammatory process is not observed, then the doctor may recommend conservative treatment or minimally invasive procedures. Large tumors, as well as complications in the form of suppuration or infection, require surgical treatment.

There are additional methods that are prescribed to prevent the development of complications. To do this, use magnetotherapy, reflexology, exposure to vacuum, heat or ultrasound.

The choice of therapeutic regimen depends on the results of the examination. First you need to find out the root cause of the neoplasm and its size. If the cyst is complicated by an inflammatory process, in order to stop the pathological process, stop the growth of the neoplasm, and also prevent changes in the glandular tissue, hormones, antibiotics, painkillers, enzymes of animal origin and antispasmodics are prescribed. These funds normalize blood circulation in the pelvis and improve the functioning of the gland. In some cases, rectal suppositories are prescribed.

Treatment of prostate cysts with Folk remedies must be agreed with your doctor, as some herbs can accelerate tumor growth. The most common traditional medicine:

• burdock tincture;
• black cumin essential oil;
• infusion of flaxseeds, birch leaves, harrow.

The use of traditional medicine is an additional treatment and must be combined with traditional therapy.

If a man has problems with urination, the doctor may recommend a puncture of the prostate cyst. This is a minimally invasive operation performed under ultrasound guidance. Liquid is pumped out of the process on the prostate gland - this is a simple and safe procedure.

Another minimally invasive way to treat cysts on the prostate is sclerosis. In addition to pumping out the fluid, in this case, a special drug is injected into the cystic cavity, which glues the walls of the neoplasm.

In case of ineffectiveness of conservative and minimally invasive methods of therapy, surgical intervention is prescribed:

Forecast and prevention

To prevent the formation of a cystic neoplasm, provoking factors must be minimized. It is not recommended to overexert yourself with a full bladder, and it is also necessary to avoid hypothermia. It is important to remember that absolutely any catarrhal disease can negatively affect the functions of the prostate, so you need to treat all pathologies in a quality and timely manner.

A healthy lifestyle, moderate physical activity, proper nutrition, intimate hygiene, avoiding casual relationships - these are the main aspects of preventing prostate cysts. It is also recommended to undergo an annual examination by a urologist, especially for men after 35 years. With timely diagnosis and proper treatment, the prognosis for recovery is favorable.

Prostate cyst: all about the causes, symptoms, treatment and consequences

A prostate cyst (bubble) is a non-physiological cavity with walls filled with liquid exudate. It is diagnosed in men over 50 years of age who have problems in the reproductive system (acquired). Congenital prostate cysts are less common and associated with other anatomical anomalies. Cystic neoplasms have a benign course, malignant degeneration is possible under adverse conditions. On the principles of treatment of the disease further.

Causes

A cyst in the prostate of a congenital nature is discovered by chance during a routine examination of the reproductive organs. It occurs due to abnormal development of the genital organs. The causes of acquired cysts in the prostate are more extensive:

• Hypersecretion of the prostate glands.
• Recurrent prostatitis.
• Trauma, fibrosis of the prostate tissue.
• Benign hyperplasia (adenoma).
• Narrowing of the prostatic ducts.
• Stagnation in the pelvic organs (with hypodynamia).
• Irregular or too active sex life.
• Varicosis in the small pelvis.
• Hard work, frequent heavy lifting.
• Malignant tumor in the prostate.
• Prostate surgery

A cystic formation in the prostate gland is more often formed against the background of chronic prostatitis or, conversely, a growing bladder provokes inflammation in the glandular organ. The outflow of prostatic secretion decreases, a cavity with walls of differentiated tissue is formed, and fluid accumulates in it. As the capsule grows, the contents begin to put pressure on adjacent tissues, causing pain.

Benign Limited Liquid Capsule

Wall cells are differentiated

Cells alien to the body with uncontrolled growth

Does not grow into neighboring tissues, exerts pressure during growth

Grows into nearby tissues and organs, destroys them

May twist, rupture, causing life-threatening conditions

Capable of growing to enormous sizes, metastasizing throughout the body

Can be formed in all organs of the human body

Can occur in any tissue and organ

The prostatic cyst is usually localized within the healthy tissue of the gland due to two mechanisms - a violation of the outflow of prostatic secretion and its excessive production. Initially, a small bubble of fibrous tissue is formed, which is gradually filled with a secret of various colors and densities. As the exudate accumulates, the dimensions of the cavity increase, the walls thicken, it begins to put pressure on neighboring tissues, causing pain and discomfort.

Varieties of pathology

The cyst of the prostate is differentiated by etiology, origin and localization. It can be true (a consequence of the pathology of the prostate gland) or false (accumulation of secretion in violation of its outflow).

Acquired - retention cyst, benign cystic hyperplasia, ejaculatory duct cyst, parasitic, cystic cancer. Congenital - due to anomalies of the Mullerian canals, seminal vesicles, uterine gland. The cavity walls are composed of squamous and columnar epithelium. Single or multiple cysts are classified according to the place of formation:

• A cyst on the background of prostate adenoma is a consequence of degenerative processes in the nodes of adenoma. Cystic cavities are small - 1-10 mm.
• Cyst of the vas deferens (funicolocele) - formed in the spermatic cord.
• Prostate parenchyma cyst - small size, not clinically manifested.
• Prostatic uterine cyst is a congenital pathology, the bubble is formed in the area of the blind pocket.
• Peripheral cyst - must be differentiated from prostate cancer, which develops in 80% of cases in this place.
• Cyst of the seminal tubercle (Kulikovy head) - a mound on the back wall of the prostatic part of the urethra.

Manifestations of prostate cysts are nonspecific and are in many ways similar to the prostatitis clinic. The severity of symptoms depends on the size, location and nature of the pathological process. Polycystic prostate may be accompanied by a cyst of the left kidney and BPH.

How the disease manifests itself

Small solitary cysts do not manifest and are an incidental finding during a routine examination or ultrasound. Concerned about voluminous bubbles or numerous. If the capsule compresses the urethra, the outflow of urine is disturbed and typical "prostatic" signs appear.

• Frequent urge to urinate, need to strain.
• Feeling of incomplete emptying of the urea, weak jet.
• Pain during intercourse, aggravated during ejaculation.
• Discomfort in the perineum and anus at rest.
• Erectile dysfunction, premature ejaculation.
• Retrograde ejaculation is the reflux of semen into the bladder.
• Subfebrile temperature.

The symptoms of a prostate cyst are nonspecific, so it is not possible to accurately determine the disease based on a single history. An examination is required to clarify the diagnosis. Instrumental research plays an important role in the diagnosis of pathology.

Clinical Research

A cyst in the prostate gland as a diagnosis is made on the basis of a comprehensive examination, including:

• History taking and examination of the patient.
• Finger rectal prostate palpation
• Laboratory tests of blood, urine.
• Spermogram, prostatic secretion testing.
• Instrumental research methods.
• Biopsy (histological test).

The initial examination gives a presumptive assessment of the size, consistency and shape of the prostate. If they differ from the norm, biochemical tests and ultrasound are prescribed. The disadvantage of abdominal ultrasound is the low accuracy and approximate results. Small formations on a conventional ultrasound can not be seen. Before the procedure, it is necessary to fill the bladder, which is inconvenient for most patients with prostatic problems.

Trusi (transrectal ultrasound) is a more modern diagnostic method. Allows you to see the bubbles with a diameter of 10 mm. A strong increase in the volume of the prostatic gland requires histological clarification - rectally, according to ultrasound control, a puncture of the prostate cyst is performed.

MRI (magnetic resonance imaging) and CT (computed tomography) are currently the most informative diagnostic methods that allow you to see layer-by-layer sections of an organ in the desired projection. They are distinguished by high resolution, are able to determine the structure, parameters and localization of small cysts.

If necessary, the examination of the prostate expands uroflowmetry - the determination of the rate of urination. Urethrocystography is often prescribed - a contrast study of the urethra and bladder.

How and what to treat

The treatment of prostate cysts depends on the clinical situation and is determined by the doctor after examining the patient. The chosen therapy option depends on the clinical case.

Dynamic observation - in case of inadvertent detection of a cyst no larger than 2 mm in size without any symptoms. A cause for concern will be an increase in the parameters of the cyst. Single microcysts often resolve on their own after sanitation of the inflammatory focus in the prostate.

Conservative treatment is indicated when cavity formations larger than 6 mm are detected. With the ineffectiveness of drug therapy, surgery is performed.

Puncture of the cyst followed by suction of the exudate. It is carried out in cases of urination disorders when squeezing the urethra with a bulk bladder.

Sclerosis (gluing) of the cyst walls with a special preparation that is injected into its cavity. The procedure may be preceded by puncture and sanitation.

Surgical excision. It is prescribed for the impressive size of the cavity and the presence of a purulent process in it.

Folk treatment

It is possible to treat a prostate cyst with folk remedies only at an early stage, when the size of the cavity is not more than 2 mm. Popular recipes.

Tincture of walnut shells - pour 0.5 liters of alcohol into the shells of 15 walnuts, leave for 14 days, strain. Take daily 1 tbsp. l.

Pumpkin juice. Drink a glass of freshly squeezed pulp juice daily twice a day.

Burdock tincture - 400 ml of burdock leaf juice is mixed with 100 ml of vodka. Take 1 tbsp. l. daily before meals for 2 weeks.

Folk remedies for prostate cysts are not the main treatment. Their use must be agreed with the attending physician. Self-medication can cause irreparable harm to health.

Drug therapy

It is possible to cure a prostate cyst at an early stage with a conservative method. Drug treatment includes drugs of different pharmacological groups.

Non-steroidal analgesics (Diclofenac, Keiver, Movalis, Ibuprofen). Drugs of the NSAID group can cause irritation of the gastric mucosa, in the treatment of them it is advisable to use the form of rectal suppositories.

Antibiotics (Augmentin, Norfloxacin, Ofloxacin) are prescribed to sanitize the inflammatory focus in the prostate gland. The appointment of antibacterial agents is in the competence of the attending doctor. Antibiotics are treated for 7-10 days.

Alpha-blockers (Tamsulosin, Doxazosin). Prescribed by a doctor to improve urination.

In a chronic inflammatory process that is difficult to treat, a short course of hormone therapy is prescribed. Episodic injections of Diprospan or Dexamethasone are prescribed.

To improve blood circulation and trophism of the pelvic area, venotonics and capillary protectors (Aescusan, Detralex, Phlebodia) are recommended. A cyst in the prostate gland is treated on an outpatient basis, subject to regular examinations and periodic diagnostics.

Surgery

If conservative treatment is ineffective, an operation is performed to remove the cyst. It is possible to get rid of cavity formation in several ways.

Sclerotherapy (drainage) - used to remove large cysts. The cavity is treated with ethyl alcohol, which causes sclerosis and drying of the cystic walls.

Laser enucleation - removal of a cyst with a laser. Through the urethra, special instruments are introduced, by means of which tissues are melted (cut off), and they are sucked off with a vacuum.

Laparoscopy - endoscopic removal through a small hole (1-1.5 cm). Low-traumatic operation.

Laparotomy is an operation through an incision. The choice of access to the prostate is carried out after the examination, may change during the operation. Possible ways to the gland - through the anterior abdominal wall, urethra, perineum, transrectal. Surgical intervention involves excision of the walls of the bladder, sometimes the removal of the prostate area is required.

The choice of removal method depends on the size of the tumor, location and severity of the pathological process. The method of treatment is chosen by the doctor.

Physiotherapy

Physiotherapy treatment is prescribed in the presence of small formations. The acceleration of recovery occurs due to the activation of metabolic processes and includes.

• Magnetotherapy.
• Vacuum treatment.
• Ultrasound therapy.
• Healing vibrations.
• Reflexology.

Physiotherapy eliminates stagnation, improves blood supply and innervation in the organ, restores the patency of the ducts. Physiotherapy is useful in the presence of a cyst of the ejaculatory duct. Relief comes after the first sessions, pain disappears, erection improves, libido increases.

Prostate massage for a cyst: can you do it or not

Massage of the prostate with a cyst is not recommended - this can provoke a rupture of the cyst with all the ensuing consequences. Massaging the prostate may result in bacterial prostatitis and obstruction of the prostate ducts by stones.

Consequences and forecasts of doctors

A small cyst with adequate treatment does not pose a health hazard. A large cavity tumor can lead to a complication. Among the troubles:

• Ishuria (acute retention of urine) against the background of the blockage of the urethral lumen by a bladder.
• Ischemia and atrophy of parts of the gland as a result of compression and deformation of the vessels that feed the organ.
• Spontaneous opening of the cavity leads to infection of the surrounding tissues with cystic contents.
• Suppuration of the cystic fluid, the occurrence of an abscess.
• Calcification in the prostate.
• Erectile problems, reduced fertility, infertility.
• Malignant degeneration (prostate cancer).

The discovery of a tumor, even a benign one, in the reproductive organ becomes an unpleasant surprise for many men. A small cyst in the prostate can lead to complications, and any doctor will explain why this disease is dangerous. Treatment should be timely.

How to avoid a cyst in the prostate

No man is immune from the occurrence of a cyst in the prostate. By adhering to a number of rules, you can significantly reduce the likelihood of its occurrence. For this you need:

• Avoid hypothermia and heavy lifting.
• Be sexually active on a regular basis.
• Timely treat inflammation of the genitourinary system.
• Avoid sexually transmitted infections.
• Regularly see a urologist.

The appearance of the slightest discomfort during urination or during sexual relations is a reason to visit a specialist. A small bubble in the prostate that is left unattended can later cause a more serious complication.