Seminal Vesicle Cyst Excision

Video presents robotic assisted excision of cyst in region of seminal vesicles. 57 years old patient complaining for intense perineal pain since 6 months. MRI demonstrated 3 cm cyst near midline. Seminal vesicle cysts can be congenital or acquired. Congenital cysts occur due to insufficient drainage as a result of atresia of the ejaculatory ducts causing distension of seminal vesicles and further leading to the formation of a cyst. They usually become symptomatic in young adulthood due to the accumulation of secretions. These cysts are mostly unilateral with no predilection for side of involvement. Acquired cysts are seen most often secondary to prostatic infection or surgery causing scarring and finally obstruction of the drainage of secretions. This is seen most often bilaterally. Age of presentation of congenital cysts is during the period of greatest reproductive activity i.e in 2nd and 3rd decades of life while acquired cysts are most often seen in the elderly age group. Smaller cysts may be detected incidentally. In symptomatic patients, the usual presenting features include perineal pain, abdominal pain, ejaculatory pain, dysuria, haematuria, increased frequency of micturition, urinary tract infections and infertility. Author of video: Ali Moinzadeh MD, director of robotic surgery at Lahey Clinic Medical Center, Institute of Urology, Burlington, MA, USA.