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Rajamohan N, Kapoor H, Khurana A, Nelson L, Ganesh HS, Khatri G, Nair RT. MR imaging of penile pathology and prostheses. Abdom Radiol (NY) 2024:10.1007/s00261-024-04417-2. [PMID: 39066812 DOI: 10.1007/s00261-024-04417-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 07/30/2024]
Abstract
Penile MRI is a vital yet underutilized diagnostic tool that provides detailed information crucial for managing various penile pathologies. Due to its infrequent use, many radiology trainees lack confidence in interpreting these exams. This article reviews the anatomy, key technical considerations, and interpretive pearls for penile trauma, Peyronie's disease, priapism, penile neoplasms, prosthesis evaluation, and a few miscellaneous conditions. Through illustrative case examples, this review aims to enhance the understanding and proficiency of radiologists in performing and interpreting penile MRI in these clinical scenarios.
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Affiliation(s)
- Naveen Rajamohan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9004, USA.
| | - Harit Kapoor
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
| | - Aman Khurana
- Department of Radiology, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Leslie Nelson
- Department of Radiology, University of Wisconsin, Madison, 600 Highland Ave, Madison, WI, 53792, USA
| | - Halemane S Ganesh
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
| | - Gaurav Khatri
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9004, USA
| | - Rashmi T Nair
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
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2
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Dimitrov R, Stamatova-Yovcheva K. MRI Anatomical Investigation of Rabbit Bulbourethral Glands. Animals (Basel) 2023; 13:ani13091519. [PMID: 37174556 PMCID: PMC10177450 DOI: 10.3390/ani13091519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Anatomical MRI is appropriate for the interpretation of soft tissue findings in the retroperitoneal part of the pelvic cavity. The aim of the current study was to use rabbits as an imaging model to optimize MRI protocols for the investigation of bulbourethral glands. The research was conducted on twelve clinically healthy, sexually mature male rabbits, eight months of age (New Zealand White), weighing 2.8 kg to 3.2 kg. Tunnel MRI equipment was used. The transverse MRI in the T2-weighted sequence obtained detailed images that were of higher anatomical contrast than those in T1-weighted sequences. The hyperintensity of the glandular findings at T2, compared to the adjacent soft tissues, was due to the content of secretory fluids. The quality of the anatomical tissue contrast has not shown much dependence on the choice of the sequence in dorsal MRI. The sagittal visualization of the rabbit bulbourethral glands corresponded to the localization of the research plane toward a median plane. The imaging results could be used as a morphological base for clinical practice and reproduction.
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Affiliation(s)
- Rosen Dimitrov
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Kamelia Stamatova-Yovcheva
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
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Muacevic A, Adler JR. Cowper's Syringocele: A Literature Review. Cureus 2022; 14:e32583. [PMID: 36540322 PMCID: PMC9757912 DOI: 10.7759/cureus.32583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Cowper's syringocele is a rare but underdiagnosed cystic dilatation of the main ducts of Cowper's gland. It is becoming more widely known in the adult population. Recent research proposes that syringoceles should be categorized according to the intraductal pressures causing ductal dilatation from mild to gross ultimately involving the gland itself. Although there may be some overlap in the clinical manifestations of different syringoceles, mildly dilated ducts are frequently asymptomatic. Moreover, moderate to gross duct dilatations can manifest as lower urinary tract symptoms (LUTS) or obstructive symptoms. A valid differential diagnosis is essential because these symptoms can be found in a wide range of severe illnesses. Syringocele can be diagnosed by ultrasonography in combination with voiding retrograde/antegrade cystourethrogram (VCUG), nevertheless, other procedures like cystourethroscopy, CT scan, and MRI scans can be helpful. Initially, conservative surveillance is advised, but if necessary, endoscopic marsupialization or surgical excision is the preferred treatment modality to address persistent problems.
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4
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Adasonla K, Pathak S, Li CY. Large, infected Cowper’s syringoceles: a rare cause of perineal sepsis in adult men. J Surg Case Rep 2022; 2022:rjac568. [DOI: 10.1093/jscr/rjac568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Urologists and general surgeons alike are familiar with assessing acute perineal pathology. A Cowper’s gland syringocele is a rare cystic dilatation of the male bulbourethral gland, typically seen in children. We report the diagnosis and emergency management of two adult cases of large, infected Cowper’s gland syringoceles. A comorbid 76-year old was diagnosed with sepsis and penile swelling, but there was no discrete superficial pathology. Magnetic resonance imaging (MRI) revealed a perineal collection communicating with the membranous urethra. A suprapubic catheter was inserted, and aspiration was attempted. Meanwhile, a 55-year-old diabetic presented with severe perineal pain. MRI revealed a deep perineal collection, involving the scrotum and proximal penis. He improved with antibiotics and aspiration of the collection. This rare diagnosis may be more common in older men than previously thought. Pelvic MRI is a key diagnostic tool. A minimally invasive approach is possible in those with considerable perioperative risk.
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Affiliation(s)
- Kelvin Adasonla
- Whipps Cross University Hospital Department of Urology, , London E11 1NR , UK
| | - Sandeep Pathak
- Whipps Cross University Hospital Department of Radiology, , London E11 1NR , UK
| | - Chi-Ying Li
- Whipps Cross University Hospital Department of Urology, , London E11 1NR , UK
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Kizilgoz V, Kantarci M, Tonkaz G, Levent A, Ogul H. Incidental findings on prostate MRI: a close look at the field of view in this anatomical region. Acta Radiol 2022; 64:1676-1693. [PMID: 36226365 DOI: 10.1177/02841851221131243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has been widely used as an advanced imaging modality to detect prostate cancer and indicate suspicious areas to guide biopsy procedures. The increasing number of prostate examinations with MRI has provided an opportunity to detect incidental lesions, and some might be very significant to elucidate patient symptoms or occult neoplastic process in the early stages. These incidental lesions might be located in the prostate gland, adjacent tissues, or organs around the prostate gland or out of the genitourinary system. The field of view of prostate MRI includes not only the prostate gland but also other critical pelvic organs in this specific anatomical region. Some of these incidental lesions might cause the same symptoms as prostate cancer and might explain the symptoms of the patient, and some might indicate early cancer stages located outside the prostate. Reporting these lesions might be life-saving by initiating early disease treatment. Awareness of the predicted locations of congenital anomalies would also be beneficial for the radiologists to mention these incidental findings.
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Affiliation(s)
- Volkan Kizilgoz
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Mecit Kantarci
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey.,Faculty of Medicine, Department of Radiology, 37503Atatürk University, Erzurum, Turkey
| | - Gokhan Tonkaz
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Akin Levent
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey.,Faculty of Medicine, Department of Radiology, 37503Atatürk University, Erzurum, Turkey
| | - Hayri Ogul
- Faculty of Medicine, Department of Radiology, Düzce University, Düzce, Turkey
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Takahashi H, Potretzke TA, Kawashima A, Cheville JC, Masuoka S, Kim B. Imaging of the Bulbourethral (Cowper) Gland: Abnormalities and Differential Diagnosis. Radiographics 2022; 42:2037-2053. [PMID: 36149823 DOI: 10.1148/rg.220099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Normal Cowper glands and ducts are imperceptible at imaging. However, abnormalities of the Cowper glands and ducts are increasingly seen owing to increasing use of cross-sectional imaging. In this article, the authors present a comprehensive review of the normal anatomy of the Cowper glands and ducts and the clinical and imaging findings of conditions that affect them in an effort to help lead to appropriate diagnosis and management. A Cowper duct syringocele is a congenital or acquired dilatation of the Cowper duct in the bulb of the corpus spongiosum. Retrograde urethrography is the standard test to diagnose a communicating (open) Cowper duct syringocele, and MRI is used for further morphologic assessment. Cowperitis refers to inflammation of the gland and/or duct, and recurrent cowperitis is usually associated with an underlying syringocele, a urethral fistulous connection to the Cowper gland, or a perianal fistula. MRI allows detection of the underlying structural abnormality and the superimposed inflammation. Cowper stones are typically radiopaque and are found in both the Cowper gland and duct. A Cowper gland HHhemorrhagic cyst may be incidentally detected at MRI of the prostate, and follow-up MRI may be required to ensure evolution of hemorrhage and exclude an underlying neoplasm. Cowper gland carcinoma is rare and includes adenocarcinoma and adenoid cystic carcinoma subtypes. Transperineal US may be used for initial evaluation and CT and/or MRI are necessary for further characterization and staging. Cowper gland hyperplasia is a rare entity with few previous reports that may be incidentally detected at imaging and may mimic malignancy. ©RSNA, 2022.
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Affiliation(s)
- Hiroaki Takahashi
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
| | - Theodora A Potretzke
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
| | - Akira Kawashima
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
| | - John C Cheville
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
| | - Sota Masuoka
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
| | - Bohyun Kim
- From the Department of Diagnostic Radiology (H.T., T.A.P., B.K.) and Department of Laboratory Medicine and Pathology (J.C.C.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (A.K.); and Department of Diagnostic Radiology, University of Tsukuba, Tsukuba, Japan (S.M.)
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7
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Becerra MF, Smith N, Bhat A, Shah HN. Endoscopic management of adolescent closed Cowper's gland syringocele with holmium:YAG laser. Asian J Urol 2022; 9:340-342. [PMID: 36035349 PMCID: PMC9399538 DOI: 10.1016/j.ajur.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Maria F Becerra
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Nicholas Smith
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Abhishek Bhat
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Hemendra N Shah
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Bugeja S, Frost A, Ivaz S, Dragova M, Andrich DE, Mundy AR. Syringoceles of Cowper's ducts and glands in adult men. Asian J Androl 2021; 22:129-133. [PMID: 31274476 PMCID: PMC7155803 DOI: 10.4103/aja.aja_59_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Cowper's syringoceles are uncommon, usually described in children and most commonly limited to the ducts. We describe more complex variants in an adult population affecting with varying degrees of severity, the glands themselves, and the complications they may lead to. One hundred consecutive urethrograms of patients with unreconstructed strictures were reviewed. Twenty-six patients (mean age: 41.1 years) with Cowper's syringoceles who were managed between 2009 and 2016 were subsequently evaluated. Presentation, radiological appearance, treatment (when indicated), and outcomes were assessed. Of 100 urethrograms in patients with strictures, 33.0% demonstrated filling of Cowper's ducts or glands, occurring predominantly in patients with bulbar strictures. Only 1 of 26 patients with non-bulbar strictures had a visible duct/gland. Of 26 symptomatic patients, 15 presented with poor flow. In four patients, a grossly dilated Cowper's duct obstructed the urethra. In the remaining 11 patients, a bulbar stricture caused the symptoms and the syringocele was identified incidentally. Eight patients presented with perineal pain. In six of them, fluoroscopy and magnetic resonance imaging (MRI) revealed complex multicystic lesions within the bulbourethral glands. Four patients developed perineoscrotal abscesses. In the 11 patients with strictures, the syringocele was no longer visible after urethroplasty. In three of four patients with urethral obstruction secondary to a dilated Cowper's duct, this resolved after transperineal excision (n = 2) and endoscopic deroofing (n = 1). Five of six patients with complex syringoceles involving Cowper's glands were excised surgically with symptomatic relief in all. In conclusion, Cowper's syringocele in adults is more common than previously thought and may cause lower urinary tract symptoms or be associated with serious complications which usually require surgical treatment.
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Affiliation(s)
- Simon Bugeja
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Anastasia Frost
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Stella Ivaz
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Mariya Dragova
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Daniela E Andrich
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Anthony R Mundy
- Reconstructive Urology Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
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9
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Silverii H, Houle K, Rovner E. Persistent Dysuria in a Young Male. Urology 2020; 148:e29-e30. [PMID: 33159920 DOI: 10.1016/j.urology.2020.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022]
Abstract
A Cowper's Duct syringocele is a rare diagnosis and currently there exists no clinical guidelines for evaluation and management. This clinical challenge illustrates the case presentation, evaluation, diagnosis, and treatment options for of a newly diagnosed Cowper's Duct syringocele.
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Affiliation(s)
- Hailey Silverii
- Department of Urology, Medical University of South Carolina, Charleston, SC
| | - Katherine Houle
- Department of Urology, Medical University of South Carolina, Charleston, SC
| | - Eric Rovner
- Department of Urology, Medical University of South Carolina, Charleston, SC.
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10
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Patel S, Rai J. Successful treatment of a rare Cowper’s bulbourethral gland syringocele in an adult with endoscopic laser deroofing using a rigid ureteroscope. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415820949390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cystic dilatation of Cowper’s glands, also known as a syringocele, is a well-known condition of childhood, with increased recognition as a rare presentation of urinary tract symptoms in adults. Surgical techniques for its treatment vary, with several described in the literature. However, consensus on optimal treatment is unclear. We present a rare case of a Cowper’s gland syringocele successfully treated with laser deroofing with a previously undescribed method using a rigid ureteroscope, and we also review techniques in the literature. Level of evidence: Level 5.
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Affiliation(s)
- Sheena Patel
- Department of Urology, University Hospitals of Leicester NHS Trust, UK
| | - Jaskarn Rai
- Department of Urology, University Hospitals of Leicester NHS Trust, UK
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Wagemans MEHM, Tsachouridis G, Kuijper CF, de Mooij KL, Klijn AJ, de Jong TPVM. Cowper's syringocele in the pediatric population: a retrospective study of 122 patients. J Pediatr Urol 2019; 15:546-551. [PMID: 31270025 DOI: 10.1016/j.jpurol.2019.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVE Syringocele is a rare cystic dilatation of the duct of Cowper's gland, afflicting mostly the pediatric population. Syringoceles have a wide range of symptoms and may cause urethral obstruction. The authors analyzed to clarify the clinical manifestation, diagnostic approach, management, and incidence in the pediatric population. MATERIALS AND METHODS All patients (122 cases) diagnosed with a syringocele at the department of Pediatric Urology in a tertiary referral university children's hospital between August 1991 and October 2016 were analyzed retrospectively by assessing medical charts. RESULTS The clinical manifestation, diagnostic findings, and follow-up are summarized in the table. Half of the patients (50.0%) also had typical posterior urethral valves (PUVs) and/or a single valve in the 12 o'clock position (flap-valve). The symptoms of open and closed syringoceles showed no significant difference. Treatment consisted of incision of the syringocele with a diathermia hook. The incidence of urinary tract infection (UTI) before and after surgery in the group that had a syringocele only was significant different. The overall incidence of syringoceles seen at urethrocystoscopy in this series was 3.0%. DISCUSSION This series suggests that the presenting age is strongly related to the consequences of syringoceles, as the youngest half of the patients had significantly more UTIs at presentation than older patients, who presented with significantly more obstructive voiding symptoms, postvoiding residuals, and incontinence. In addition, the younger group had a significantly higher incidence of vesicoureteral reflux and dilatation of the upper urinary tract. The found association between syringoceles and PUV may be due to overgrowth of epithelium, as possible origin in both anomalies. CONCLUSION With an incidence of 3.0%, syringoceles, in this tertiary referral series, should be considered in the differential diagnosis of obstructive urethral lesions. The presentation ranges between signs of severe obstructions in the prenatal and postnatal period to mild urinary incontinence problems at later age. Urethrocystoscopy proved to be useful in confirming the diagnosis and allows for immediate transurethral incision.
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Affiliation(s)
- M E H M Wagemans
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands
| | - G Tsachouridis
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands; Department of Pediatric Urology, University Children's Hospitals Amsterdam UMC, the Netherlands
| | - C F Kuijper
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands; Department of Pediatric Urology, University Children's Hospitals Amsterdam UMC, the Netherlands
| | - K L de Mooij
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands; Department of Pediatric Urology, University Children's Hospitals Amsterdam UMC, the Netherlands
| | - A J Klijn
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands; Department of Pediatric Urology, University Children's Hospitals Amsterdam UMC, the Netherlands
| | - T P V M de Jong
- Department of Pediatric Urology, University Children's Hospital UMC Utrecht, the Netherlands; Department of Pediatric Urology, University Children's Hospitals Amsterdam UMC, the Netherlands.
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Sørensen FE, Skott M, Rawashdeh YF, Kirkeby HJ. Syringocele: a retrospective study and review of the literature. Scand J Urol 2019; 53:269-274. [PMID: 31411088 DOI: 10.1080/21681805.2019.1649719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
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.
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Affiliation(s)
| | - Martin Skott
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
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Matta I, Chalhoub K, Abou Zahr R, Ghazal G, Huyghe E, Nohra J. A Case of Symptomatic Cowper's Syringocele in an Adult Male: Diagnosis and Management. J Endourol Case Rep 2019; 5:56-59. [PMID: 32760801 DOI: 10.1089/cren.2019.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- Imad Matta
- Department of Surgery, Division of Urology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Khalil Chalhoub
- Department of Surgery, Division of Urology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Rawad Abou Zahr
- Department of Surgery, Division of Urology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Georges Ghazal
- Department of Surgery, Division of Urology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Eric Huyghe
- Department of Urology, Andrology and Renal Transplant, Toulouse University Hospital, Toulouse, France
| | - Joe Nohra
- Department of Surgery, Division of Urology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
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14
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Saadat P, Borzi P, Patel B, Winkle D. Urethral syringocele: unseen but existing. ANZ J Surg 2019; 89:743-746. [PMID: 30836430 DOI: 10.1111/ans.15039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bulbourethral syringocele is an uncommon and under-diagnosed condition most commonly seen in the paediatric population, although there is increasing recognition in adults. Due to the difficulty in diagnosis, we report our experience of urethral syringocele in a quaternary paediatric hospital, with differing presentations, diagnosis and treatment. METHODS This is a retrospective review of seven cases of children over a period of 14 years, including their presentations, diagnosis, treatment and follow-up. A review of the current literature is presented. RESULTS The median age of these seven cases at presentation was 11 years (6 days to 16 years). Clinical features varied with age, with obstructive uropathy in a neonate, urinary tract infection in an infant, scrotal abscess in two children and lower urinary tract obstructive symptoms in three teenagers. Diagnostic voiding cystogram diagnosed the majority of syringoceles and two were seen on magnetic resonance imaging. Five boys underwent endoscopic transurethral deroofing and two children required transperineal marsupialization. Long-term follow-up showed all had complete resolution of symptoms. CONCLUSION Urethral syringocele presents from the neonatal period to late adolescence, with the presenting features reflective of age. Surgical management can be performed endoscopically or by open approach. Awareness of this condition and inclusion in the differential diagnosis, particularly in the setting of an atypical or recurrent scrotal abscess, could avoid a prolonged therapeutic course.
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Affiliation(s)
- Paria Saadat
- Department of Urology, The University of Queensland, Mater Hospital Brisbane, Brisbane, Queensland, Australia
| | - Peter Borzi
- Department of Paediatric Surgery, The University of Queensland, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Bhavesh Patel
- Department of Paediatric Surgery, The University of Queensland, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - David Winkle
- Department of Urology, The University of Queensland, Mater Hospital Brisbane, Brisbane, Queensland, Australia.,Department of Paediatric Surgery, The University of Queensland, Queensland Children's Hospital, Brisbane, Queensland, Australia
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15
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Dual Pathology Causing Congenital Bladder Outlet Obstruction. Urology 2017; 154:e19-e20. [PMID: 29225122 DOI: 10.1016/j.urology.2017.11.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/08/2017] [Accepted: 11/28/2017] [Indexed: 11/21/2022]
Abstract
Anterior urethral syringocele is an uncommon congenital deformity characterized by cystic dilatation of bulbourethral gland ducts and is usually asymptomatic. We present a case on 4-day-old male neonate who presented with bilateral antenatal hydroureteronephrosis and renal impairment and found to have urethral syringocele and posterior urethral valves.
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Abstract
Background: Cowper's syringocele is a rare condition, uncommon in the adult population. It is more common in the pediatric population. Patients could be asymptomatic or present with irritative and/or obstructive symptoms. Ultrasonography (US) of perineal region, pelvis MRI, or urethrography are the most often used diagnostic modalities. Surgical treatment is indicated in all symptomatic patients. Endoscopic approach is preferred over open surgery. Unroofing of syringocele with cold knife or holmium yttrium aluminium garnet (YAG) laser is effective treatment. Case Presentation: A 17-year-old Caucasian male presented at our emergency department with irritative symptoms. US of perineal region showed cystic formation near urethra. Pelvis MRI showed Cowper's gland syringocele. Endoscopic unroofing with holmium YAG laser was performed. Six months postoperatively the patient was asymptomatic and satisfied with the treatment. Conclusion: Cowper's syringocele is a rare condition. Urologist should consider this condition in pediatric and adolescent patients with irritative and/or obstructive symptoms. Pelvis MRI and perineum US are the main diagnostic tools. Surgical treatment is effective. Endoscopic approach is preferred. Open surgery is indicated in complicated cases and in cases when endoscopic treatment fails.
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Affiliation(s)
- Milena Taskovska
- Department of Urology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Simon Hawlina
- Department of Urology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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17
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Floyd MS, Omar AM, Khattak AQ. A rare case of suspected perineal nodular induration. Can Urol Assoc J 2017; 11:288. [PMID: 28798834 DOI: 10.5489/cuaj.4716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Michael S Floyd
- Department of Reconstructive Urology, Whiston Hospital, St. Helens & Knowsley Hospital NHS Trust, Liverpool, United Kingdom
| | - Ahmad M Omar
- Department of Reconstructive Urology, Whiston Hospital, St. Helens & Knowsley Hospital NHS Trust, Liverpool, United Kingdom
| | - Altaf Q Khattak
- Department of Reconstructive Urology, Whiston Hospital, St. Helens & Knowsley Hospital NHS Trust, Liverpool, United Kingdom
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18
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Blasl F, Rösch WH, Koen M, Ardelean MA, Ebert AK. Cowper's syringocele: A rare differential diagnosis of infravesical obstruction in boys and young adults. J Pediatr Urol 2017; 13:52.e1-52.e5. [PMID: 27746247 DOI: 10.1016/j.jpurol.2016.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 08/29/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE AND INTRODUCTION Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels et al. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. STUDY DESIGN We retrospectively collected clinical data of 12 children and young adults from birth to 18.5 years (median 7.2 years) who had been treated in four different institutes during a period of 16 years. The primary specific diagnostic work-up consisted of ultrasound, cystourethrography, and cystoscopy. RESULTS 3Older patients with a median age of 11.8 years clinically presented with obstructive voiding pattern or gross hematuria; infants with a median age of 0.6 years presented with febrile urinary tract infections (UTIs). After cystoscopic confirmation in all patients, endoscopic treatment was possible in nine; open surgical resection was necessary in three patients. Because of intrauterine megacystis and chronic renal failure, one boy underwent suprapubic diversion with a cystostomy soon after birth. Owing to urological comorbidity or later complications, additional procedures were necessary, for example, resection of minor urethral valves, prophylactic circumcision for UTI, endoscopic or open antireflux procedures, and occasionally complex bladder reconstructions in the long term. DISCUSSION According to our data, the initial clinical symptoms of Cowper's syringocele were related to presenting age rather than the previously described type of syringocele according to Maizels et al. Infants presented with febrile UTIs; however, older boys and young adults had mainly voiding problems or nocturnal enuresis. Therefore, the clinical significance of the described syringocele types must be questioned. Eighty-three percent of our patients showed additional urological pathology such as vesicoureterorenal reflux, ureteropelvic junction obstruction, megaureter, or minor urethral valves. Thus, Cowper's syringocele hardly seems to be an isolated pathology. CONCLUSION Although rare, Cowper's syringoceles should be considered in differential diagnosis of infravesical obstruction in boys and young adults. Diagnostics are usually justified by presenting symptoms such as UTI or urinary flow impairment, which seem to be age dependent. Despite modern diagnostic tools, diagnosis is usually made by cystourethrography and sometimes accidentally by cystoscopy. Considerable urological comorbidities and consecutive bladder dysfunction need long-term follow-up.
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Affiliation(s)
- Felix Blasl
- Department of Urology, Katharinenhospital, Stuttgart, Germany.
| | - Wolfgang H Rösch
- Department of Pediatric Urology, University Medical Center, Regensburg, Germany
| | - Mark Koen
- Department of Pediatric Urology, Krankenhaus Barmherzige Schwestern, Linz, Austria
| | | | - Anne-Karoline Ebert
- Department of Urology and Pediatric Urology, Medical University Ulm, Ulm, Germany
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Mittal PK, Camacho JC, Sahani DV, Kalb B, Harri PA, Master V, Kokabi N, Hartman M, Kitajima HD, Moreno CC. Hematospermia Evaluation at MR Imaging. Radiographics 2016; 36:1373-89. [PMID: 27517360 DOI: 10.1148/rg.2016150195] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Hematospermia is a challenging and anxiety-provoking condition that can manifest as a single episode or recur over the course of weeks to months. It is usually a benign self-limiting condition in younger sexually active males without a history of risk factors such as cancer, urogenital malformations, bleeding disorders, and their associated symptoms. However, patients with recurrent, refractory and painful hematospermia with associated symptoms, such as fever, pain, or weight loss, require evaluation through clinical assessment and noninvasive investigations to rule out underlying pathologic conditions such as ejaculatory obstruction, infectious and inflammatory causes, malignancy, vascular malformations, and systemic disorders that increase the risk of bleeding, especially when presenting in older men. If these investigations are negative, the patient should be reassured and treated accordingly. In the recent past, magnetic resonance (MR) imaging has assumed a major role in the investigation of hematospermia due to its excellent soft-tissue contrast and multiplanar capabilities. In this review, we will discuss the potential causes of hematospermia and its diagnostic workup, including pathophysiology, anatomic considerations, the imaging appearance of associated pathologic conditions, and management. (©)RSNA, 2016.
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Affiliation(s)
- Pardeep K Mittal
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Juan C Camacho
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Dushyant V Sahani
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Bobby Kalb
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Peter A Harri
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Viraj Master
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Nima Kokabi
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Matthew Hartman
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Hiroumi D Kitajima
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
| | - Courtney C Moreno
- From the Department of Radiology and Imaging Sciences (P.K.M., J.C.C., P.A.H., N.K., H.D.K., C.C.M.) and Department of Urology (V.M.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; Department of Radiology, Massachusetts General Hospital, Boston, Mass (D.V.S.); Department of Medical Imaging, University of Arizona School of Medicine, Tucson, Ariz (B.K.); and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.)
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Transurethral Unroofing of a Symptomatic Imperforate Cowper's Syringocele in an Adult Male. Case Rep Urol 2016; 2016:3743607. [PMID: 27119039 PMCID: PMC4826926 DOI: 10.1155/2016/3743607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 03/21/2016] [Indexed: 11/29/2022] Open
Abstract
Cystic dilatation of bulbourethral gland ducts (Cowper's gland syringocele) is a rare abnormality. The condition has been described among pediatric populations, but it is uncommon in adults. It can be asymptomatic or present with obstructive and irritative urinary symptoms. We report a case of a symptomatic imperforate Cowper's syringocele in a young patient that was successfully managed with transurethral unroofing of the cyst.
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21
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An unusual perineal mass in a male cyclist. Int Urol Nephrol 2016; 48:371-2. [PMID: 26725080 DOI: 10.1007/s11255-015-1198-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/20/2015] [Indexed: 10/22/2022]
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22
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Nork JJ, Yap MK, Kaplan GW. Verumontanum Cyst Associated With Lower Urinary Tract Symptoms in an Adolescent. Urology 2015; 88:192-4. [PMID: 26498735 DOI: 10.1016/j.urology.2015.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 11/18/2022]
Abstract
Urinary tract polyps occur anywhere from the renal pelvis to the anterior urethra. Lower tract polyps occur less frequently than upper tract polyps and are a rare finding in children. Symptoms include obstruction, dysfunctional voiding, or hematuria. We report the case of a 17-year-old male who presented with persistent leakage of urine following voiding. Ultrasound demonstrated a small cystic lesion in the posterior aspect of the prostate and a voiding cystourethrogram was suggestive of a utricular cyst or polyp. He underwent a cystoscopy that demonstrated a large cystic structure originating from the verumontanum, nearly obstructing the prostatic urethra.
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Affiliation(s)
- Justin J Nork
- Department of Urology, Naval Medical Center San Diego, San Diego, CA.
| | - Mike K Yap
- Rady Children's Hospital San Diego, San Diego, CA
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A Case of Giant Cowper's Gland Syringocele in an Adult Male Patient. Case Rep Urol 2015; 2015:682042. [PMID: 26413368 PMCID: PMC4568031 DOI: 10.1155/2015/682042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 08/05/2015] [Indexed: 11/17/2022] Open
Abstract
Cowper's gland syringocele is an uncommon, underdiagnosed cystic dilatation of Cowper's gland ducts showing various radiological patterns. Herein we report a rare case of giant Cowper's gland syringocele in an adult male patient, with description of MRI findings and management outcome.
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24
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Smith GHH, Deshpande AV, Tang RWK. Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature. Urol Ann 2014; 6:75-9. [PMID: 24669129 PMCID: PMC3963350 DOI: 10.4103/0974-7796.127018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 07/21/2012] [Indexed: 11/04/2022] Open
Abstract
Anterior urethral diverticula are rare in children. Anterior urethral valves and associated diverticulum is the commonly discussed pathological entity in children. There is a lack of awareness among clinicians regarding less common presentations of anterior urethral diverticula in children; which can have a diverse involvement of the urinary tract. This report describes two uncommon presentations of anterior urethral diverticula in children, their diagnoses and management. A systematic differential diagnosis and review of anterior urethral diverticula in children is also presented.
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Affiliation(s)
- Grahame H H Smith
- Department of Urology, The Children's Hospital at Westmead, Sydney, Australia
| | - Aniruddh V Deshpande
- The Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Robert W K Tang
- Department of Urology, The Children's Hospital at Westmead, Sydney, Australia
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Satish KKV, Mammen A, Ratani AA, Varma KK. Posterior urethral valves and Cowper's syringocele: A rare association causing voiding dysfunction. J Indian Assoc Pediatr Surg 2012; 17:126-7. [PMID: 22869980 PMCID: PMC3409902 DOI: 10.4103/0971-9261.98133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Urethral syringoceles are cystic dilatations of paired bulbourethral glands of Cowper. They can cause voiding dysfunction in male children and usually occur in isolation. We report a rare association of Cowper's syringocele with posterior urethral valves in a 4-year-old child, which was successfully managed endoscopically.
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Affiliation(s)
- Kumar K V Satish
- Department of Neonatal and Pediatric Surgery, Malabar Institute of Medical Sciences (MIMS), Calicut, Kerala, India
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