Anterior urethral diverticulum produced by Cowper's gland duct cyst

Syringocele: a retrospective study and review of the literature

Background: A syringocele is a cystic dilation of the ducts from the bulbourethral glands located in the bulbous part of the male urethra. It is a rare condition primarily reported in children and young adults. The objective was to evaluate the diagnostic pattern and management strategy in patients of all ages diagnosed with syringocele.Methods: A retrospective review of patients with syringocele in the period 2004-2018 was performed. Age at diagnosis, primary symptoms, the diagnostic modalities used, treatments and effects were registered.Results: In the period, 19 patients with syringoceles were identified, eight children and 11 adults. The majority of the patients presented with obstructive voiding symptoms. All patients underwent cystourethroscopy. Supplementary diagnostics as voiding cystourethrography, retrograde urethrography, uroflowmetry, magnetic resonance imaging or transrectal ultrasonography were used inconsistently. Sixteen of the patients underwent marsupialization, one child underwent open excision and two patients were managed conservatively. Three of the children were re-operated on with endoscopic marsupialization. One of the adult patients did not respond to marsupialization and was treated with and vesico-appendico-cutaneostomy.Discussion: A review of the case reports published in the period 1996-2018 was performed and compared to these results. This review found 77 cases, 50 children and 27 adults. The reported symptoms, diagnostics and treatments were in line with the findings of this study.Conclusions: Based on these findings and the literature it is recommended that syringoceles should be diagnosed by cystourethroscopy and urethrography. Patients with symptomatic syringoceles should be offered treatment. First line treatment is endoscopic marsupialization.

A neglected gland: a review of Cowper's gland

Cowper's glands are pea sized glands present inferior to the prostate gland in the male reproductive system. They produce thick clear mucus prior to ejaculation that drains into the spongy urethra. Though it is well established that the function of the Cowper's gland secretions is to neutralize traces of acidic urine in the urethra, knowledge regarding the various lesions and associated complications of this gland is scarce. This review provides a comprehensive report on the development, function and various lesions associated with Cowper's gland.