Abstract
BACKGROUND: Parameatal urethral cysts are rare, benign cystic lesions at the urethral meatus, most often occurring in females during childhood. Fewer than 100 cases have been documented, and their pathogenesis remains unclear. This case series describes the symptoms, histological characteristics, and postoperative outcomes of two adolescent males with parameatal urethral cysts and provides an updated review of the literature. CASE PRESENTATION: Two male adolescents (Ages 16 and 17) without prior medical history presented with cystic lesions at the ventral urethral meatus. One reported mild voiding discomfort and altered urinary stream, while the other experienced discomfort and intermittent pain. Both described gradual cyst enlargement over several years. Examination revealed clear, fluid-filled cysts measuring 1-2 cm. Each underwent complete cyst excision. Pathology demonstrated a urothelial-type cyst in one case and a mixed-type cyst in the other. RESULTS: Both patients demonstrated excellent postoperative cosmesis and complete symptom resolution at 1-month follow-up. CONCLUSION: Parameatal urethral cysts are rare benign lesions of uncertain origin. Patients typically present due to discomfort or cosmetic concerns. Complete surgical excision remains the gold standard, offering excellent cosmetic and functional outcomes with minimal recurrence risk. These cases contribute to the limited literature and reinforce excision as the preferred treatment.