Cowper duct syringocele refers to a cystic dilatation of the main duct of the bulbourethral (Cowper) glands.
Affected patients may present with postvoid dribbling, urinary frequency, weak stream, or hematuria.
Four groups of syringoceles have been described 2:
- simple syringocele
- minimally dilated duct
- most frequent
- perforate syringocele
- bulbous duct that drains into the urethra via a patulous ostium
- can appear as a diverticulum
- imperforate syringocele: bulbous duct that resembles a submucosal cyst and appears as a radiolucent mass
- ruptured syringocele: fragile membrane that remains in the urethra after a dilated duct ruptures
May be seen a unilocular cystic lesion at the posterior or posterolateral aspect of the posterior urethra 8.
Usually seen as a midline oval structure at the penile base adjacent to the ventral aspect of the proximal bulbous urethra.
- T2: high signal intensity
Treatment and prognosis
Treatment options include surgical incision of the obstructed duct (considered generally curative).
- 1. Pretorius ES, Siegelman ES, Ramchandani P, Banner MP. MR imaging of the penis. Radiographics : a review publication of the Radiological Society of North America, Inc. 21 Spec No: S283-98; discussion S298-9. doi:10.1148/radiographics.21.suppl_1.g01oc24s283 - Pubmed
- 2. Maizels M, Stephens FD, King LR, Firlit CF. Cowper's syringocele: a classification of dilatations of Cowper's gland duct based upon clinical characteristics of 8 boys. The Journal of urology. 129 (1): 111-4. Pubmed
- 3. Moskowitz PS, Newton NA, Lebowitz RL. Retention cysts of Cowper's duct. Radiology. 120 (2): 377-80. doi:10.1148/120.2.377 - Pubmed
- 4. Yaffe D, Zissin R. Cowper's glands duct: radiographic findings. Urologic radiology. 13 (2): 123-5. Pubmed
- 5. Bevers RF, Abbekerk EM, Boon TA. Cowper's syringocele: symptoms, classification and treatment of an unappreciated problem. The Journal of urology. 163 (3): 782-4. Pubmed
- 6. Melquist J, Sharma V, Sciullo D, McCaffrey H, Khan SA. Current diagnosis and management of syringocele: a review. International braz j urol : official journal of the Brazilian Society of Urology. 36 (1): 3-9. Pubmed
- 7. Türker Köksal I, Erdoğru T, Usta M, Ateş M, Baykara M. Unexpected presentation of syringocele. Acontractile bladder. Urologia internationalis. 71 (2): 222-3. doi:71853 - Pubmed
- 8. Shebel HM, Farg HM, Kolokythas O, El-Diasty T. Cysts of the lower male genitourinary tract: embryologic and anatomic considerations and differential diagnosis. Radiographics : a review publication of the Radiological Society of North America, Inc. 33 (4): 1125-43. doi:10.1148/rg.334125129 - Pubmed
- 9. Selli C, Nesi G, Pellegrini G, Bartoletti R, Travaglini F, Rizzo M. Cowper's gland duct cyst in an adult male. Radiological and clinical aspects. Scandinavian journal of urology and nephrology. 31 (3): 313-5. Pubmed
- 10 . Kickuth R, Laufer U, Pannek J, Kirchner TH, Herbe E, Kirchner J. Cowper's syringocele: diagnosis based on MRI findings. Pediatric radiology. 32 (1): 56-8. doi:10.1007/s00247-001-0580-8 - Pubmed