Cowper’s Duct Syringocele Mimicking Prostatic Obstruction: A Case Report
Abstract
Introduction: Cowper’s glands, also known as bulbourethral glands, were first described by French surgeon Jean Mery in 1684 and later detailed by William Cowper in 1699. Cowper’s duct syringocele, a rare condition involving cystic dilatation of Cowper’s gland, can mimic symptoms of prostatic obstruction, posing diagnostic challenges. Common presentations include lower urinary tract symptoms (LUTS) such as urgency, weak stream, and incomplete emptying, often leading to misdiagnosis as benign prostatic hyperplasia (BPH). Accurate diagnosis involves imaging studies like transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI), along with retrograde urethrography and cystourethroscopy. Management varies from conservative measures to surgical intervention, depending on symptom severity. Case Presentation: A 36-year-old male presented with urinary obstruction symptoms, reporting a poor stream and straining to urinate over three months, with exacerbation characterized by incomplete voiding. No hematuria, UTIs, or urolithiasis history was noted. Examination was largely unremarkable, except for a flat prostate on per rectal examination. Uroflowmetry indicated a maximum flow rate (Qmax) of 15 ml/sec with an interrupted pattern. MRI revealed a cystic lesion in the posterior urethra, raising suspicion for Cowper’s duct syringocele. Diagnostic cystoscopy confirmed the cystic dilatation, which was deroofed using monopolar energy. The patient’s recovery was uneventful, with…
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