Prostatic utricle cyst

Prostatic utricle cyst (PUC) is an area of focal dilatation that occurs within the prostatic utricle.

They are midline cystic masses in the male pelvis and can be very difficult or impossible to distinguish from a Mullerian duct cyst.

Utricle cysts are most often detected in the 1st and 2nd decades of life (Mullerian duct cysts usually occur in the 3rd and 4th decades). 

The incidence of prostatic utricle cyst ranges around 11-14% in association with hypospadias or intersex anomalies and up to 50% in the presence of perineal hypospadias 3.

Clinical presentation is variable and includes pelvic mass, obstructive and irritative urinary tract symptoms, haematuria, and suprapubic or rectal pain.

Urine may pool in utricle cysts, since they communicate with the urethra, occasionally resulting in post-void dribbling. Some patients may be asymptomatic.

Prostatic utricle cysts always arise from the level of the verumontanum and are always in the midline. Mullerian duct cysts can arise anywhere along the path of Mullerian duct regression, from scrotum to utricle.

Utricle cysts are variable in size but are usually smaller (commonly <10 mm) than Mullerian duct cysts and usually do not extend above the prostate gland (Mullerian duct cysts typically extend above the prostate gland).

Association of prostatic utricle cysts with a variety of genitouninany abnormalities is recognized and include:

Mullerian duct cysts have no such associations 1.

Seen as midline prostatic cyst

  • utricle cysts may contain pus or haemorrhage if infected
  • utricle cysts may contain cancer (e.g. clear cell carcinoma, or squamous cell carcinoma) with a reported prevalence as high as 3%
Prostate pathology
Share article

Article information

rID: 12441
System: Urogenital
Section: Gamuts
Tag: cases, cases
Synonyms or Alternate Spellings:
  • Prostatic utricle cyst (PUC)
  • Utricle cyst
  • Utricle cysts
  • Prostatic utricle cysts
  • Utricle cyst of prostate
  • Utricular cyst of the prostate
  • Prostate utricular cyst
  • Prostatic utricular cyst

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Prostatic utricle...
    Case 1: retrograde cystoscopy
    Drag here to reorder.
  • Drag
    Prostatic utricle...
    Case 1: ultrasound
    Drag here to reorder.
  • Drag
    TRUS showing midl...
    Case 2: probable
    Drag here to reorder.
  • Drag
    Case 3: MRI
    Drag here to reorder.
  • Updating… Please wait.

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.