PICTORIAL

Brunn’s Cyst: A Rare Cause of Bladder Outlet Obstruction in a Young 
Man

Stephen Lalfakzuala Sailo,* Laltanpuii Sailo

A 27-year-old man presented with obstructive voiding symptoms for eight years. His American Urological As-sociation (AUA) symptom score was 25 with bother score of 4. Physical examination was unremarkable. He 
had normal urinalysis, and urine culture was sterile. He had a peak urine flow rate of 10 mL/s in a voided volume of 
174 mL. Bladder ultrasound showed a 1.4 × 1.2 cm cystic mass at the bladder neck (Figure 1) and an intravenous 
urography revealed bilateral hydroureteronephrosis. Cystoscopic examination showed a normal urethra, a bulge 
at the bladder neck and upon retro-flexion, a large cystic mass was noted at the bladder neck between 7 and 12 
o’clock position (Figure 2). Transurethral de-roofing and resection of the cystic mass was done using resection 
loop. The pathological examination showed features of Brunn’s cyst (Figure 3). After the operation, the obstruc-
tive voiding symptoms subsided and he voided with a peak flow rate of 18 mL/s in a voided volume of 253 mL. 
Cystoscopy done three weeks after the operation revealed no residual lesion. Bladder outlet obstruction caused by 
Brunn’s cyst has been reported previously.(1,2) De-roofing and resection is curative. Brunn’s cyst should be consid-
ered as one of the rare causes of bladder outlet obstruction.

REFERENCES
 1. Franco I, Eshghi M, Schuttle H, Srinivasan K, Addonizio JC. Bladder neck obstruction secondary to 

Brunn’s cyst. J Urol. 1988;139:126-7.
 2. Grimsby GM, Tyson MD, Salevitz B, Smith ML, Castle EP. Bladder outlet obstruction secondary to a 

Brunn’s cyst. Curr Urol. 2012;6:50-2.

Figure 1. Bladder ultrasound demonstrating a 1.4 × 
1.2 cm cystic mass at the bladder neck.

Figure 2. Cystoscopic examination demonstrating a 
large cystic mass at the bladder neck between 7 and 
12 o’clock position.

Figure 3. Histopathology demonstrates features 
of Brunn’s cyst.

Department of Urology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), 
Shillong, Meghalaya, India.
*Correspondence: Department of Urology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences 
(NEIGRIHMS), Shillong, Meghalaya, India.
Tel: +91 364 2538006. Fax: +91 364 2538010. E-mail: stephensailo@gmail.com.
Received April 2015 & Accepted September 2015

Vol 12 No 05   September-October  2015   2381