Benign Retrovesical Pelvic Mass in Men : Diagnostic and Management Dilemma

ABSTRACT

Aim: To identify the diagnostic difficulties and management issues of benign pelvic masses in males and high light the diagnostic protocol for these rare pelvic masses. Methods: A prospective single center study over a period of six years and three months. History, physical examination, operative findings and histopathological (HPE) diagnosis were recorded. Results: A total of 20 male patients presented with retrovesical mass, aged 17 to 65 years old (mean age 36.7 years) were evaluated. masses were found to be of prostatic origin in seven cases (5 prostatic utricle cyst and 2 prostatic abscess), connective tissue in seven, seminal vesicle origin in four, mullerian duct remnant in one case, and embryonic urogenital vestigial remnants in one case. Of these 20 patients, 19 presented with acute or chronic lower urinary tract symptoms and in one case, the mass was asymptomatic and found incidentally. Ultrasound showed cystic lesions in 17 patients and solid masses in three. Nine cases underwent exploratory laparotomy. Further biopsies of specimen demonstrated tissue of origin in all cases (8/9) except one. HPE report confirmed the same clinical and operative diagnosis in six cases. Conclusion: Benign retrovesical mass presents with lower tract obstructive symptoms, palpable pelvic mass and retention of urine. Needle or open biopsy is required in most cases to establish a histopathological diagnosis. Benign retrovesical mass is rare, we faces difficulty in diagnosis and management. Hence, diagnostic protocols can be helpful to manage retrovesical pelvic masses.