[Transurethral unroofing of the müllerian duct cyst: a case report]

Management of Müllerian duct cyst depends on the size and symptomatology. Here we report a case of recurrent Müllerian duct cyst which was treated successfully by transurethral approach. A 57-year-old man was first admitted because of dysuria in 1981. Under the diagnosis of Müllerian duct cyst, he underwent resection of the cyst by suprapubic retrovesical approach that resulted in incomplete extirpation. In 1982, he was readmitted for recurrence of the cyst. Excision by transsacral approach was unsuccessful because of severe adhesion. He was followed by periodic puncture of the cyst and alcohol instillation. In 1988, he was hospitalized because of persistent urinary symptoms. Since open surgical procedure was thought to be difficult, it was replaced by transurethral management. A cyst bulging into the trigone was found with a cystoscope and the bladder wall over the cyst was resected transurethrally until the cyst was entered. A 2 cm opening between the bladder and the cyst was created with a resectoscope. Follow up CT scan two months later demonstrated sufficient communication between the bladder and the cyst. The patient voided well with no discomfort. We believe that transurethral unroofing of the cyst provides a safe treatment in selected cases.