Prostatic utricle cyst causing ejaculatory duct obstruction and persistent haemtospermia
Presentation
The patient presented with persistent hematospermia and painful ejaculation.
Patient Data
There is a well defined cystic lesion seen in the midline of the prostate, consistent with a prostatic utricle cyst, it appears hyperintense on T1 and hypointense on T2, representing hemorrhagic content.
There is also a T1 hyperintense, T2 hypointense signal filling the left seminal vesicles and minimally seen in the right seminal vesicles, representing a hemorrhagic content.
Few tiny well-defined hypointensities in the left seminal vesicles are seen, compatible with seminal vesicle stones.
Features are collectively representing a complicated prostatic utricle cyst, resulting in ejaculatory duct obstruction with secondary seminal vesicles hemorrhage (hematospermia) and seminal vesicles stones.
Case Discussion
Obstruction of the ejaculatory ducts may be a congenital anomaly such as ejaculatory duct atresia and prostatic utricle cyst, but can also be acquired, secondary to urogenital infections or trauma.
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