Laparoscopic extraperitoneal excision of a symptomatic anterior midline periprostatic cyst: A case report

Anterior midline periprostatic cysts are rare and may cause lower urinary tract symptoms due to compression of the membranous urethra. We report a 44-year-old man with progressive voiding symptoms. Perineal ultrasound and pelvic MRI revealed a 12 × 25 mm anterior midline periprostatic cyst clearly separated from the prostatic parenchyma and compressing the urethra. Because of its deep anterior location and the risk of sphincter injury with transurethral approaches, laparoscopic extraperitoneal excision was performed. The cyst was completely removed without complications, and symptoms improved markedly (IPSS 18 to 5). • Anterior midline periprostatic cysts are rare causes of obstructive LUTS • Extraperitoneal laparoscopy allows safe and complete cyst excision • Urinary symptoms improved markedly after surgery