Introduction:In general, cysts of the median raphe of the penis are asymptomatic. Objective: To present a rare case of parameatal cyst of the penis, which caused loss of self-confidence, impaired sexual satisfaction and disturbance of the urinary stream. Main outcome measures were effect of negative penis image on man and consequent impact on satisfaction with sexual intercourse and personal distress. Methods: A 34-year-old married man sought consultation for a painless cystic mass with abnormal shape of glans penis. The man reported significant emotional distress associated with the image of his penis. He was not satisfied with his sexual life. Psychological analysis of the patient was carried out by a sex psychotherapist. Before and six months after surgical excision, change in patient's emotional well-being was assessed with Self-Esteem and Relationship (SEAR) questionnaire. The International Index of Erectile Function (IIEF) was used to assess change and end point sexual satisfaction. Results: Parameatal cyst of the penis affected the patient emotionally and clearly impacted his selfesteem. Histopathological examination revealed a solitary cystic cavity. The cystic wall was consisted of stratified columnar epithelium and partly had decapitation secretion. Surgical excision was effective. No postoperative irregularity of urinary stream was noticed. The patient reported significant improvements in sexual function that was associated with positive changes in emotional well-being and sexual relationship. Conclusions: This case report supports histogenetic relationship of median raphe cyst of the penis with the urothelium. It was unusual for the sudden growth in absence of inflammatory signs or trauma. It presents the relationship between body and mind. The findings from this case suggest that there is substantial psychosocial burden associated with negative effects of penis image on confidence, self-esteem and sexual satisfaction. The perception of satisfaction with sex act was directly associated with the sense of negative penis image.