A Case of Symptomatic Cowper's Syringocele in an Adult Male: Diagnosis and Management

Background: Cowper's syringocele is cystic dilation of the excretory bulbourethral gland duct. This entity is common in the pediatric population but is rare or underdiagnosed in the adult population. Syringoceles are usually classified based on the configuration of the duct's orifice to th...

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Bibliographic Details
Published in:Journal of endourology case reports 2019-06, Vol.5 (2), p.56-59
Main Authors: Matta, Imad, Chalhoub, Khalil, Abou Zahr, Rawad, Ghazal, Georges, Huyghe, Eric, Nohra, Joe
Format: Article
Language:English
Subjects:
Adults
Case Reports
Communication
Cysts
Endoscopy
Lasers
NMR
Nuclear magnetic resonance
Pediatrics
Population
Ultrasonic imaging
Urogenital system
Urology
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Summary:Background: Cowper's syringocele is cystic dilation of the excretory bulbourethral gland duct. This entity is common in the pediatric population but is rare or underdiagnosed in the adult population. Syringoceles are usually classified based on the configuration of the duct's orifice to the urethra with symptoms varying between irritative and/or obstructive accordingly. To the best of our knowledge, only few cases were reported in the literature. Case Presentation: We present the case of a 27-year-old male patient presenting with obstructive lower urinary tract symptoms. Pelvis MRI, retrograde urethrography, and flexible cystourethroscopy were performed and a diagnosis of imperforate Cowper's syringocele was made. Endoscopic unroofing with holmium:YAG laser was performed. The patient is free of symptoms 12 months postoperatively. Conclusion: Cowper's syringocele is a rare entity that should be considered in certain adult patients presenting with either storage or voiding symptoms. Ultrasonography is useful in detecting closed cystic lesions; however, antegrade urethrography and retrograde urethrography are gold standards to rule out communication with the urethra. Symptoms tend to resolve spontaneously and initial treatment is conservative. With persistent symptoms, endoscopic unroofing or marsupialization with cold knife or holmium:YAG laser is recommended as standard treatment.
ISSN:2379-9889
2379-9889
DOI:10.1089/cren.2019.0011