Cowper's Gland Syringocele.

Cowper's gland syringoceles are rare cystic dilations of the Cowper's gland duct. They are typically diagnosed in childhood but occasionally occur in adults. We report the case of a 28-year-old man who presented with a painful perineal and inferior scrotal mass and was found to have a large Cowper's gland syringocele extending into the scrotum associated with a scrotal abscess. Treatment consisted of surgical excision. The magnetic resonance imaging findings of this case are described.

Transrectal ultrasonographic characterization of the accessory sex glands, pelvic urethra, and ureters in normal geldings.

Transrectal ultrasound of the internal urogenital tract may be used to aid in the diagnosis of reproductive tract and urinary tract pathology in both stallions and geldings. Abnormalities of the accessory sex glands of geldings are uncommon, although prostatic masses have recently been described in adult geldings presenting with dysuria, stranguria, and/or hematuria. The purpose of this study was to describe the normal ultrasonographic features and sizes of the accessory sex glands, caudal ureters, and pelvic urethra in clinically normal geldings. Eleven healthy geldings with no history of urogenital tract pathology were evaluated by a single observer experienced in ultrasound of the stallion accessory sex glands. The ultrasonographic appearance, relative anatomic relationships and sizes of the accessory sex glands, caudal ureters, and pelvic urethra were investigated using both rectal linear array and microconvex array transducers. Summary statistics including mean, standard error, confidence intervals, and range were calculated for each structure. There were no statistically significant differences in measurements between the left and right sides of paired structures or between measurements obtained with different transducers. Fluid was present in the seminal vesicles of 7 of 9 subjects. Midline cysts of the urethra as well as bulbourethral gland and prostatic cysts were identified. The normal reference ranges defined in this study will be useful in the clinical evaluation of geldings with suspected internal urogenital tract pathology.

[Cowper's syringocele as cause of low urinary tract symptoms in a young man].

Cowper's syringocele (CS) is a very rare deformity of male urethra causing obstructive voiding symptoms. This case presents a 39-year-old man suffering from classical low urinary tract symptoms for five years, though without nocturia. The work-up showed normal prostate-specific antigen level, benign conditions by digital rectal examination, and normal-sized prostate on ultrasound. An urodynamic study showed outlet resistance and a supplementary ultrasound of prostate indicated a cyst structure around it. The magnetic resonance imaging confirmed a CS. Marsupialisation is the treatment of choice and was implemented.

Cowper's syringocele in an adult.

Cowper's syringocele is cystic dilatation of the excretory bulbourethral gland duct. It is an uncommon condition and is usually reported in children. There are only ten previous case reports of late presentation in adulthood to the best of our knowledge. We present the imaging findings of such a case manifesting at 30 years of age.

Cowper's glands and ducts: radiological findings in children.

PURPOSE: The aim of this study was to describe the radiological features of simple or dilated (syringocele) Cowper's ducts in a large paediatric population. MATERIALS AND METHODS: Voiding cystourethrography procedures performed during the past 24 years were evaluated taking into special account urethral morphology. The procedures were performed to study all sorts of possible urinary affections. RESULTS: A total of 1,676 male children (age: newborn to 18 years) underwent 2,340 voiding cystourethrographies. Opacification of Cowper's ducts was observed in nine children (0.53%) - in six (0.35%) as a thin, radiopaque image running parallel to the inferior edge of the membranous-bulbar urethra and in three (0.18%) as a dilated structure (syringocele); this was a source of significant voiding problems. CONCLUSIONS: Opacification of Cowper's ducts - even if rare - has to be recognised as a possible anatomical finding during voiding cystourethrography in paediatric patients. An accessory finding devoid of pathological meaning in most cases, it can, however, be a possible cause of voiding disorders in some instances.

Efficacy of transrectal ultrasonography in the evaluation of hematospermia.

OBJECTIVE: To assess the efficacy of transrectal ultrasonography (TRUS) in the evaluation of hematospermia. MATERIAL AND METHODS: This study included 54 patients with hematospermia. Patients age range was between 25 and 75 years (mean=49.7 years). All patients were evaluated by TRUS using a biplane transducer and a Toshiba SSA-270A device. RESULTS: TRUS revealed one or more abnormalities in 51 patients (94.5%). Prostatic calcifications were found in 23 patients, ejaculatory duct calculi in 21, dilated ejaculatory ducts in 18, benign prostatic hyperplasia in 18, dilated seminal vesicles in 12, calcifications in seminal vesicles in 11, ejaculatory duct cyst in 6, prostatitis in 6, and periurethral Cowper gland mass in 1. CONCLUSION: TRUS is a noninvasive, safe method for the investigation of causes of hematospermia. We believe that it should be the first radiological investigation to be performed in patients presenting with hematospermia.

[Cowper's gland: anatomic, physiological and pathological aspects]. / Glandes de Cowper: aspects anatomique, physiologique et pathologique.

Cowper's glands are small appendages of the male genital tract, that are sometimes observed on intravenous urography voiding films. They are involved in the immune defence of the genitourinary tract, play a role in fertility, and secrete many glycoproteins, including PSA. They can be visualized in the form of a duct image parallel to the urethra, sometimes associated with opacification of the gland on IVU. This image can be differentiated from a fistula, extravasation of contrast agent, urethral duplication, or an artefactual image, by the course parallel to the urethra, the upper limit not exceeding the urogenital diaphragm, and the position of the orifice. These glands can be affected by neoplastic, infectious, stone and especially cystic disease: syringocele. The physician should think of these glands in patients with unusual genitourinary symptoms in order not to miss disease of these organs, and to prescribe appropriate treatment.

Cowper's syringocele: an analysis of 15 consecutive cases.

Cystic dilatation of Cowper's gland ducts (Cowper's syringocele) is uncommon in children and is frequently asymptomatic, but it may cause urinary infection, haematuria, dysuria, and obstructive voiding symptoms. Fifteen consecutive children with syringocele aged 15 days to 15 years old are reported here. Only four patients with obstructive syringocele were successfully treated surgically; all the others were successfully treated conservatively. The true clinical significance of Cowper's syringocele lies in its potential to cause urethral obstruction. Careful clinical, radiological, endoscopic, and urodynamic evaluation is necessary in order to avoid unnecessary surgery.

A study of the relationship between syringoceles and Cobb's collar.

OBJECT: To assess the association between the congenital narrowing of the bulbar urethra and syringoceles. MATERIALS AND METHODS: Eleven boys were investigated, 10 with a cystogram and 9 with video endoscopy. The video tapes were reviewed with the radiology and the relationship between the syringocele and the narrowing of the bulbar urethra (Cobb's collar) was particularly noted. RESULTS: Seven of the 9 boys examined endoscopically were found to have a Cobb's collar near the proximal extent of the syringocele; the proximal extent of external sphincter appeared to be above and separate from the syringocele in all cases. Six of 10 patients had a syringocele and bulbar urethral narrowing seen at cystogram. CONCLUSIONS: It would appear that syringoceles are often associated with a Cobb's collar, in keeping with the possible origin of both structures from the region of the urogenital membrane. The narrowing in the bulbar urethra may, however, be an incidental finding in many of the cases.

[Cowper's syringocele in children: report on ten cases]. / Il siringocele delle ghiandole di Cowper in età pediatrica. A proposito di 10 osservazioni.

Cystic dilatation of Cowper's gland ducts (Cowper's syringocele) is uncommon in pediatric age. Cowper's syringocele frequently are asymptomatic, sometimes may cause dysuria, pollakiuria and obstructive voiding symptoms. We report ten children with syringocele. Five were observed for recurrent urinary infections, three for obstructive voiding symptoms and two for post-traumatic hematuria and for urinary incontinence. Only three patients with obstructive urethral symptoms were surgically treated. In our opinion careful clinical, radiologic and endoscopic evaluation is necessary in such cases so that unnecessary surgery can be avoided.

Cowper's glands duct: radiographic findings.

Lesions of Cowper's glands duct are uncommon findings in a urethrogram. Three types of anomaly are described in 11 patients. The most frequent type is a slightly dilated duct, which is usually asymptomatic, with or without associated urethral pathology. The other less common types are perforate Cowper's duct and retention cyst, which are usually symptomatic and not associated with other urethral pathologies.

Syringocele, a rare lesion of Cowper's gland.

Syringocele are retentioncysts of Cowper's glands. First described by Fenwick, Maizels rediscovered them and made a very usefull classification. These cysts are more common than previously reported. They can be very obstructive for the urinary flow or cause no symptoms at all. Most are congenital. In our series we studied 5 patients with syringoceles. Treatment consisted in broad endoscopic unroofing. The results with this type of surgery are good. Follow-up showed all the patients to void well and to be free of other irritative symptoms.

[Syringoceles of Cowper's glands in children]. / Siringoceles de las glándulas de Cowper en niños.

Some tubular or cystic diverticula observed in the ventral wall of the male bulbous urethra that originate from dilatation of Cowper's gland ducts have been termed "syringoceles". They can cause dysuria, hematuria and obstruction. We report 14 syringoceles and 1 true diverticulum from segmental absence of spongious urethra. We review embryology, anatomy and diagnosis in order to determine the best therapeutic approach. We performed endoscopic resection of the distal valve-like border of the diverticulum in 6 patients (42.85%) with good results. The remaining 8 patients, in whom surgery was not indicated, were followed clinically and radiologically.

[Ultrasonography in syringocele of the male urethra (ultrasound-urethrography)]. / Ecografia nel siringocele dell'uretra maschile (sono-uretrografia).

The authors have studied 5 patients with syringocele--or cystic dilatation of the excretory ducts in Cowper's glands--using a 7.5 MHz linear high-definition US probe. The urethra was distended with a saline solution introduced through a small Foley's balloon catheter placed in the navicular fossa. Longitudinal and transverse scans were employed at both the penis and the perineal region. The syringocele appears on US scans as a tubular image at the bulbous urethra, parallel to the urethral canal, with a "double tube" appearance. It is easily differentiated from urethral stenosis, while it may be confused with congenital urethral duplication, which is extremely uncommon. US with a small-part probe can be considered an useful imaging technique and a valid alternative to conventional radiology, especially in young patients, to avoid high dose exposure.