Transrectal ultrasound guided drainage of prostatic cysts

Purpose: A technique for transrectal ultrasound guided drainage of prostatic cysts and large cystic utricles is described using simple adaptation of equipment readily available in the transrectal ultrasound suite. Materials and Methods: Using the puncture trajectory display generated by the ultrasound unit, the biopsy needle is manually advanced through the needle guide of the transrectal ultrasound probe. Once the tip of the needle reaches the lumen of the cystic lesion, the central trocar of the needle is removed from the outer cannula and intravenous line tubing is inserted into the opening in the trocar. The syringe is attached to the opposite end of the extension tubing, allowing for cyst aspiration. Results: This technique was performed successfully in 11 patients with symptomatic cysts within the prostate, including 7 with intraprostatic cysts and 4 with cystic utricles. The fluid collection recurred in 1 patient with a cystic utricle, causing epididymal pain and orchialgia that resolved with repeat drainage. Conclusions: This technique allows for easy, successful drainage of symptomatic prostatic cysts in an outpatient setting without specialized equipment or anesthesia.