Treatment for Penile Cysts
Benign penile cysts should be treated with complete surgical excision, which provides definitive diagnosis and cure with minimal recurrence risk. 1, 2, 3
Initial Assessment
Before proceeding with treatment, document the following characteristics:
- Location: Glans, foreskin (prepuce), or shaft—most commonly on the ventral surface 1, 2, 3
- Size and mobility: Measure dimensions and assess whether the mass is movable or fixed 1, 4
- Symptoms: Most are asymptomatic, but larger cysts may interfere with sexual function 1
- Duration: Many present since birth but become noticeable in adolescence or adulthood 1, 3
Definitive Treatment
Surgical excision is the standard treatment for penile cysts:
- Complete excision is curative and provides tissue for histopathological diagnosis 1, 2, 3
- For cysts on the prepuce, circumcision may be performed to remove the lesion entirely 1
- For shaft lesions, simple resection of the subcutaneous mass is appropriate 4
- Histopathological examination is mandatory to confirm the diagnosis and exclude other pathology 1, 4, 2
Important Differential Diagnoses
Distinguish penile cysts from other lesions that require different management:
- Lichen sclerosus: Requires clobetasol propionate 0.05% ointment and carries a 2-9% risk of penile carcinoma 5
- Penile carcinoma in situ (Tis/Ta): May be treated with topical therapy, laser (Category 2B), or surgical excision 6, 7, 8
- Other benign lesions: Glomus tumors, dermoid cysts, epidermal inclusion cysts, urethral diverticula require clinical correlation 2, 3
Post-Operative Management
- No recurrence is expected after complete excision 1
- Sexual function typically returns to normal after removal of symptomatic cysts 1
- Follow-up at one year is reasonable to confirm resolution 1
Critical Caveat
If there is any clinical suspicion for malignancy (irregular borders, ulceration, bleeding, rapid growth), biopsy is mandatory before definitive treatment to rule out penile carcinoma, which requires staging and different management algorithms 6, 5