Cowper’s syringocele (bulbourethral gland cyst)

This article presents a clinical case of a 30-year-old patient with a closed cystic lesion in the bulbourethral gland, whose clinical presentation was masked as acute prostatitis. Cowper’s syringocele is a cystic dilation (deformity) of the main duct of the bulbourethral (Cowper’s) gland. This disease is not uncommon, but is rarely identified; it is often asymptomatic, and its clinical manifestations are highly variable, depending mainly on its type (open, closed) and are similar to lower urinary tract symptoms (perineal pain, post-micturition dribble, recurrent urinary tract infection, dysuria, etc.). A syringocele should be included in the examination algorithms for boys, adolescents, and men with signs of inflammatory diseases of the urogenital system or symptoms of infravesical obstruction. Ultrasonography is informative for closed cysts (a fluid-filled cavity may be identified); a pelvic MRI scan, supplemented by ureteroscopy, allows to visualize the cyst cavity and to determine its association with the urethra. Ureteroscopy is a preferable option for surgical treatment in most cases. Key words: bulbourethral gland cyst, lower urinary tract symptoms, Cowper’s syringocele, ureteroscopy