Current diagnosis and management of syringocele: a review

Abstract

Cowper's syringocele is a rare but an under-diagnosed cystic dilation of the Cowper's ducts and is increasingly being recognized in the adult population. Recent literature suggests that syringoceles be classified based on the configuration of the duct's orifice to the urethra, either open or closed, as this also allows the clinical presentations of 2 syringoceles to be divided, albeit with some overlap. Usually post-void dribbling, hematuria, or urethral discharge indicate open syringocele, while obstructive symptoms are associated with closed syringoceles. As these symptoms are shared by many serious conditions, a working differential diagnosis is critical. Ultrasonography coupled with retro and ante grade urethrography usually suffices to diagnose syringocele, but supplementary procedures -such as cystourethroscopy, computed tomography scan, and magnetic resonance imaging -can prove useful. Conservative observation is first recommended, but persistent symptoms are usually treated with endoscopic marsupialization unless contraindicated. Upon reviewing the literature, this paper addresses the clinical anatomy, classification, presentation, diagnosis, and treatment of syringoceles in further detail.

Posterior urethral valves and Cowper′s syringocele: A rare association causing voiding dysfunction

“…Large syringoceles may occasionally need an open operation through perineal approach. [4] This case is reported here due its rarity and its association with posterior urethral valves.…”

“…Imaging with US or rarely computed tomography and magnetic resonance imaging may aid in diagnosis. [4]…”

Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature

“…Cowper's glands are two exocrine structures situated in the deep perineal pouch between fascial layers of the urogenital diaphragm. [8] Although more common in adulthood, McLellan et al . have reported that in their 40-year period in Boston there were nine children with AUD and in two of them continuity was demonstrated between the Cowper's duct and diverticulum.…”

“…[1] They have been reported to cause lower urinary tract symptoms in children in the handful of reported cases. [89] Although, most paediatric syringocele cases are asymptomatic with signs appearing in adult age, clinicians must consider them as a differential diagnosis of AUD, especially in later childhood. Our second case highlights this point.…”

A rare case of suspected perineal nodular induration

“…3,4 In addition to magnetic resonance imaging, urethrography should also be undertaken if a syringocele is suspected. 3,5 …”