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COWPER'S GLAND SYRINGOCELES IN CHILDREN: 2 CASES WITH DIFFERENT
PRESENTATIONS
Naeem SAMNAKAY, Bernardita TRONCOSO, Elizabeth GARNETT, Timothy RENSHAW, Andrew BARKER and Japinder
KHOSA
Princess Margaret Hospital, Paediatric Surgery and Urology, Perth, AUSTRALIA
PURPOSE
The aim of this study is to describe urethral syringocoele of Cowper's gland, a rare condition that can present
incidentally or with obstructive or irritative urinary tract symptoms in the paediatric population.
MATERIAL AND METHODS
2 cases are described.
Case 1 presented perinatally with unilateral antenatal severe hydrouretero-nephrosis. Immediate postnatal imaging
suggested VUJ obstruction. The syringocele was incidentally noted on cystoscopy, obstructing the urethra during
antegrade urine flow.
Case 2 presented at age 2.5 years with recurrent UTIs and straining to void. MCUG showed a trabeculated bladder with
right low grade VUR, and a rounded obstructive area of concentration of contrast in the anterior urethra on the
micturition phase. The right kidney also had scarring with 30% split function.
RESULTS
Both syringoceles were deroofed using a resectoscope with cold knife. Both boys also underwent circumcision.
Case 1 went on to have the unilateral VUJ obstruction resected and reimplanted, followed a few weeks later by a
laparoscopic left pyeloplasty for secondary left PUJ obstruction. His upper tracts are now well decompressed. He has no
trouble voiding. He has had no UTIs.
Case 2 has been followed up for 6 years. He had no further UTIs post-operatively. He has mild bladder urge symptoms
and day and night urinary incontinence, well controlled with oral anticholinergics.
CONCLUSIONS
Cowper's gland syringocele may be more common than currently realised. It can present in different ways, including
bladder out-flow obstruction. It should be considered, investigated for and treated. Long term follow-up in the setting of
bladder outflow obstruction is important.