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.
Erectile dysfunction is a common and often debilitating condition. The National Institute of Clinical Excellence (NICE) and the British Society of Sexual Medicine (BSSM) in the UK and the European Association of the Urology (EAU) have guidelines on the management of ED. This article will look at the similarities of the guidelines commenting where and how they differ.
The objective of this study was to assess whether scrotal ultrasound scan is necessary in patients with clinically suspected benign testis pathology. Patients and methods: Between January 2012 and December 2013 a total of 3297 men with a median age of 37 years (range 16-60 years) underwent a scrotal ultrasound scan performed by a mixture of radiographers and radiologists. Of these, 1378/3297 (42%) with a median age of 36 years (range 16-60 years) were included in our study; 1919 (58%) were excluded, as they were thought to have an infective, malignant or traumatic testis. Results: Twenty-six out of 1378 (1.9%) had a sinister scrotal ultrasound scan and were referred to the urology multidisciplinary team. Of these, 17/26 (65%) with a median age of 32 years (range 19-59 years) were still regarded as having a malignant pathology and underwent an orchidectomy. Histology revealed a malignant pathology in 14/17 (82%) with a median age of 32 years (range 23-52 years). Overall, 17/1378 (1.2%) had an unexpected suspicious scrotal ultrasound scan supported at the multidisciplinary team review, with 14/1378 (1%) having a confirmed malignant pathology. Conclusion: Our large retrospective study has demonstrated that 1% of men with clinically benign testis lesion will actually have an underlying unsuspected malignant pathology. Therefore, scrotal ultrasound scan should be considered in all men presenting with a testis lesion.
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