Presentation
Incidental finding on urinary tract ultrasound for lower lower urinary tract symptoms.
Patient Data
Lobulated hypoechoic mass sitting behind the bladder and prostate containing low level internal echoes.
Large, lobulated, low density mass at the left base of penis intimatetly related to the urethra at the prostatic apex.
Case Discussion
The paired Cowper (bulbourethral) glands drain into the bulbous urethra via a single duct at the base of the penis. The fluid produced plays a role in urethral lubrication and sperm motility during ejaculation. Each gland has its own duct that unites prior to urethral entry. These ducts can be obstructed either as a congenital anomaly or as an acquired condition. Cysts are usually asymptomatic but if large can cause mass effect on the adjacent urethra or perineum. Treatment is usually by unroofing at urethoscopy.
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