Fluid-filled sacs that can develop within the prostate gland are known as prostate cysts. Prostatic Cysts are rather prevalent and affects a significant number of men, particularly as they get older. Even while they are mostly harmless and asymptomatic, bigger cysts can cause substantial discomfort and consequences if they are not treated. However, researchers suggest that this condition in healthy men incidence is on a rise. This article examines the characteristics of prostate cysts, including their symptoms, the factors that lead to their development, and the most recent treatment options, which include the novel IR (Interventional Radiology) technique of Embolization.
What is a Prostate Cyst?
The prostate gland is responsible for the production of seminal fluid. Cysts of the prostatic gland are fluid-filled sac that forms in the prostate gland. Prostatic Cyst with other prostate related conditions such as enlargement of the prostate gland can be alarming and transabdominal sonographic findings help detect such conditions for them to be treated precisely and immediately. Cysts of the prostate can be broken down into a number of distinct categories, such as
Midline prostatic cyst (which include utricle cysts)
Medial Prostatic Cyst in patient represents a common variant of cyst in asymptomatic men. The midline prostatic cyst in patients requires a focused and thorough examination to determine whether the midline cyst represents a normal variant or is the cause of other symptoms. A midline prostatic cyst should be treated immediately as they can become infected and contribute to enlargement compressing adjacent tissues such as ejaculatory duct, bladder neck and urethra.
Midline Prostatic Cysts in patients are often asymptomatic and often found during imaging for other reasons. However, larger midline prostatic cyst requires immediate attention to prevent further health complications.
Ejaculatory Duct Cysts
Ejaculatory duct cysts are a rare type cysts formed in the prostate gland. They usually occur due to obstruction in ejaculatory duct.
Prostatic Utricle
Prostatic Utricle is a small indentation in the urethra at the apex urethral crest on the seminal colliculus. The prostatic Utricle refers to mullerian duct remnant in males. Studies have shown that between 5 to 8 percent of men may develop prostate cysts, with the development of these cysts becoming more common in the older age groups.
Symptoms of Cysts of the Prostate Gland
While many prostate cysts are asymptomatic in nature, larger cysts can cause various symptoms and can increase complications in patients with prostatitis. Some of the symptoms of patients with prostatic cysts are:
Lower urinary tract symptoms (LUTS)
Prostatic Cysts in the Prostate gland can lead to Lower Urinary Tract symptoms which include,
- A feeling that you can’t empty the bladder completely.
- The bladder might seem to fill up quickly which results in a constant urge to urinate.
- Urinating accidentally especially while coughing or sneezing.
- Passing increased volume of urine
- A weak urine system
Urinary retention
Larger Prostatic cysts in the prostate gland may obstruct the urinary flow, leading to retention. This might cause an unpleasant sensation for the patient causing an urge to urinate constantly. Patients with prostatitis symptoms (enlargement of the prostate) experience further difficulties due to complications of prostatic cysts.
Hydronephrosis
Inflammation of either or both kidneys is referred to as hydronephrosis. Kidney swelling occurs when urine is unable to flow from a kidney and as a result, accumulates within the organ. Hydronephrosis can also be a symptom of Prostate Cysts.
Urinary tract infections
Prostatic Cysts is common in patients of older age and can increase risk of urinary tract infections due to urinary retention and obstruction. Urine retention can cause the bladder to swell up which may result in increased discomfort and a constant urge to urinate.
Hematospermia
Hematospermia is a condition that results in the presence of blood in semen, which may occur with prostatic cysts in patients.
Causes of Prostate Cysts
Congenital factors
Congenital factors can be responsible for the development of prostate cysts by causing developmental abnormalities during the maturation of the fetus. These abnormalities can include malformations or incomplete development of the ducts of the prostate. These abnormalities can result in the collection of fluid, which can turn into prostatic cysts.
Inflammation
Chronic prostatitis can lead to prostatic cyst formation by causing long-term inflammation and subsequent scarring or blockage of the prostate ducts. This blockage prevents the normal drainage of prostatic fluid, leading to its accumulation and the formation of cysts.
Infections
Infections can cause prostate cysts to form by leading to inflammation and swelling within the prostate gland. This inflammation can block the ducts that normally drain prostatic fluid, causing fluid to accumulate and form a cyst.
Benign prostatic hyperplasia (BPH)
A condition that results in enlarged prostate is referred to as Benign Prostatic Hyperplasia (BPH). The prostate gland contributes to the production of sperm in men, and it is fairly common for the prostate gland to grow larger as one gets older. This condition can lead to the formation of prostatic cyst in patients.
Recent Treatment Options for Prostate Cysts: Traditional Methods vs. Embolization (Interventional Radiology) Technique
Prostate cysts, while often benign, can lead to significant discomfort and complications when symptomatic and can lead to patients experiencing prostatitis like symptoms. Understanding the treatment landscape is essential for those affected. This section elaborates on traditional treatment methods and introduces Embolization as an innovative option. Moreover, imaging techniques with incidence and transabdominal sonographic is a radiological evolution to detect bowel disease and other abdomen related conditions in adults.
Traditional Treatment Methods
Transrectal Aspiration
This minimally invasive procedure involves uses ultrasound guidance to aspirate the fluid from the prostatic cyst. While it can provide immediate relief, cysts may recur, necessitating the need for further intervention.
Transurethral Resection (TUR)
Transurethral Marsupialization of a prostate (TURP) is a rather complicated invasive surgical approach where the prostatic cyst is resected through the urethra. TURP can effectively alleviate symptoms but carries risks such as bleeding, infection, and potential damage to the surrounding tissues.
Marsupialization
This technique involves creating a permanent opening in the cyst to allow continuous drainage. It can be performed endoscopically and is effective for larger cysts. However, it may require hospitalization and carries risks associated as in with any other surgical approach.
Open Surgery
In rare cases, particularly when cysts are large or complicated which results in prostatitis-like symptoms, open surgical intervention may be necessary. This approach is more invasive and involves longer recovery times. While these traditional methods can be effective, they often come with risks and potential complications, leading many patients to seek alternative treatments.
IR Technique, Embolization
What is Embolization?
Embolization is an innovative technique used to treat cysts with minimal post-effects on the body. Usually, Embolization is performed by an interventional radiologist by releasing microscopic particles into the arteries that feed the growth of cyst in patients with a minimally invasive approach. These particles block the blood that flows into the cyst and then with time, the symptoms reduce completely.
While other treatments show an alarming impact on men’s health in general, Embolization involves low risks and anyone who undergoes this procedure can return back to their normal routine within a couple of days. By reducing blood flow, Embolization can lead to a minimally invasive approach and alleviate symptoms caused by prostatic cysts.
Why Choose Embolization?
- Minimally Invasive: Embolization is performed through a small incision, typically in the wrist or groin, making it less invasive than traditional surgical options.
- Short Recovery Time: Patients typically experience a quicker recovery with Embolization, often returning to normal activities within a few days compared to weeks for surgical procedures.
- Lower Risk of Complications: Embolization has a lower risk of complications such as bleeding, infection, or damage to surrounding tissues compared to traditional surgeries.
- Effective Symptom Relief: Many patients report significant improvement in urinary symptoms and overall quality of life following Embolization. Studies have shown that Embolization can effectively reduce the size of the prostate (Prostatitis) and alleviate symptoms associated with prostate cysts.
- Preservation of Sexual Function: Unlike some traditional surgical methods, Embolization has a lower risk of impacting sexual function, making it an attractive option for many men.
Conclusion
For men suffering from symptomatic prostate cysts, understanding the range of treatment options is crucial. While traditional methods like transurethral resection and marsupialization of a medial prostatic cyst have their place, Embolization which is an Interventional Radiology technique offers a promising alternative with numerous benefits. If you are experiencing symptoms related to prostate cysts, consider discussing Embolization with your healthcare provider to explore if it is the right treatment option for you.
Frequently asked questions:
1. How Serious are Prostate Cysts?
Most prostate cysts are benign and do not pose serious health risks. However, larger cysts can cause significant symptoms and complications:
- Lower urinary tract symptoms like increased urinary frequency, urgency, and difficulty urinating.
- Urinary retention due to obstruction in the bladder neck.
- Hydronephrosis which is buildup of urine in the kidneys that can lead to kidney damage
- Urinary tract infections
- Hematospermia is a condition that causes blood to be released in semen.
In rare cases, prostate cysts may also be associated with fertility problems and an increase in Prostate Specific Antigen levels, which can complicate the differential diagnosis with prostate cancer. Prompt treatment is important for symptomatic or enlarging cysts to prevent complications.
2. What is the Normal Size of a Prostate Cyst?
5-8% of men have small prostatic cysts that are typically asymptomatic and found incidentally on imaging. The size of these normal, benign cysts is usually less than 2.5 cm. larger cysts over 2.5 cm in size are less common but can cause symptoms. In one case report, a 14 mm cystic lesion was found incidentally in a 24-year-old man.
3. What is a Prostate Cyst Biopsy?
A prostate biopsy may be performed to distinguish between benign and malignant cystic lesions. During a biopsy:
A thin needle is inserted through the rectum into the prostate to obtain tissue samples and are then examined under a microscope to check for signs of cancer. For example, in a case report Prostate biopsy retrieved results that the patient was benign prostatic parenchyma with no malignancy, cystic lesion and elevated PSA.
4. Can Prostate Cysts be Treated?
Yes, prostate cysts can be treated, especially if they are causing symptoms such as:
- Small, asymptomatic cysts may just require regular monitoring.
- Larger, symptomatic cysts can be treated with:
- Transurethral resection to remove or drain the cyst
- Aspiration of the cyst fluid
- Medications like alpha-blockers to relieve urinary symptoms
- Very large pelvic masses may require open or laparoscopic surgery.
5. How to Get Rid of a Prostate Cyst Naturally?
There are no proven natural treatments to completely eliminate prostate cysts. However, some lifestyle measures may help manage symptoms:
- Staying well hydrated to promote regular urination
- Avoiding caffeine and alcohol which can irritate the bladder neck.
- Performing Kegel exercises to strengthen pelvic floor muscles
- Applying warm compresses to the perineum for pain relief.
But for most men with bothersome cysts, medical treatment is usually necessary. Consulting a urologist is recommended for proper evaluation and management.
6. Are Prostate Cysts Cancer?
No, most prostate cysts are benign (not harmful) and not cancerous. However, there are a few important points:
- Cystic prostate cancer is rare but possible.
- Certain features like irregular walls, rapid growth, or solid components within the cyst may raise suspicion for malignancy.
- Elevated PSA (Prostate Specific Antigen) levels can occur with benign cysts, complicating the differentiation from prostate cancer.
Regular monitoring and further testing like biopsy are often needed to definitively rule out cancer, especially for larger or atypical cysts. But in general, prostate cysts are much more likely to be non-cancerous.
