Successful treatment of a rare Cowper’s bulbourethral gland syringocele in an adult with endoscopic laser deroofing using a rigid ureteroscope

Abstract

Cystic dilatation of Cowper’s glands, also known as a syringocele, is a well-known condition of childhood, with increased recognition as a rare presentation of urinary tract symptoms in adults. Surgical techniques for its treatment vary, with several described in the literature. However, consensus on optimal treatment is unclear. We present a rare case of a Cowper’s gland syringocele successfully treated with laser deroofing with a previously undescribed method using a rigid ureteroscope, and we also review techniques in the literature. Level of evidence: Level 5.

Letter to the Editor re: Successful treatment of a rare Cowper’s bulbourethral gland syringocele in an adult with endoscopic laser deroofing using a rigid ureteroscope, Patel and Rai, J Clin Urol, https://doi.org/10.1177/2051415820949390

“…We read with interest the recent publication by Patel and Rai: 'Successful treatment of a rare Cowper's bulbourethral gland syringocele in an adult with endoscopic laser deroofing using a rigid ureteroscope'. 1 A case is described of a novel technique using a rigid ureteroscope and laser deroofing to treat an imperforate syringocele in a 40-year-old male who presented with lower tract symptoms and recurrent urinary tract infections. 1 The surgical technique and follow up are described, and it is notable that all symptoms resolved with this new approach although no follow up radiology or use of an objective symptom score is mentioned.…”

“…4 The variety of surgical techniques for syringocele management is described, and the authors emphasise that surgical treatment for bothersome symptoms remains the gold standard. 1 Although the majority of treatments described are endoscopic, laser-related open surgery still has a role in the management of syringoceles. 4 Case reports exist of a patient who presented with perineal pain and swelling exacerbated by cycling that eventually required open excision of a closed syringocele following urethrography and magnetic resonance imaging characterisation.…”

“…We read with interest the recent publication by Patel and Rai: ‘Successful treatment of a rare Cowper’s bulbourethral gland syringocele in an adult with endoscopic laser deroofing using a rigid ureteroscope’. 1…”

“…A case is described of a novel technique using a rigid ureteroscope and laser deroofing to treat an imperforate syringocele in a 40-year-old male who presented with lower tract symptoms and recurrent urinary tract infections. 1 The surgical technique and follow up are described, and it is notable that all symptoms resolved with this new approach although no follow up radiology or use of an objective symptom score is mentioned.…”

“…The variety of surgical techniques for syringocele management is described, and the authors emphasise that surgical treatment for bothersome symptoms remains the gold standard. 1 Although the majority of treatments described are endoscopic, laser-related open surgery still has a role in the management of syringoceles. 4…”