Cowper's syringocele: symptoms, classification and treatment of an unappreciated problem.
OBJECTIVE
Cowper's syringocele is a rare deformity in the male urethra that is a distention of the duct of the bulbourethral (Cowper's) gland. We report on 7 cases, review the symptoms and pathophysiology, and propose a simplified classification of this uncommon lesion.


METHODS
We reviewed 7 cases of Cowper's syringocele diagnosed from 1997 to 1998 at our hospital.


RESULTS
Cowper's syringocele was diagnosed in 7 patients 25 to 51 years old with persistent post-void dribbling, frequency, urethral pain, hematuria or sudden urethral discharge. Diagnosis was made with urethrocystoscopy or retrograde urethrogram. Cowper's syringocele may be closed (a distended cyst-like swelling in the wall of the urethra) or open (an opening enabling urine reflux into the syringocele). In 2 patients asymptomatic open syringocele was diagnosed. In 1 patient symptomatic syringocele resolved spontaneously following an infection. In 4 patients open syringocele was treated with transurethral marsupialization because of persistent post-void dribbling. Postoperatively patients were completely symptom-free with a mean followup of 12 months (range 6 to 23).


CONCLUSIONS
Cowper's syringocele may be more common than currently realized. Urologists should rule out this possibility in young male patients with lower urinary tract symptoms and persistent post-void dribbling as it can be treated easily.
Bevers
R F
RF
Department of Urology, Central Military Hospital and University Medical Center, Utrecht, The Netherlands.
Abbekerk
E M
EM
Boon
T A
TA
D000328:Adult; D004108:Dilatation, Pathologic / Q000145:classification / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D014521:Urethra / Q000002:abnormalities*