Pediatric urethral obstruction caused by Cowper's duct syringocele diagnosed and treated endoscopically: a case report

Cowper's duct syringocele is an uncommon and often overlooked cause of urethral obstruction in children. We report a 7-year-old boy who had experienced severe voiding difficulty, frequency, and urgency for three months and could void only while sitting. Ultrasonography, computed tomography, magnetic resonance imaging, and voiding cystourethrography were nondiagnostic. Cystourethroscopy revealed a prominent posterior urethral crest and verumontanum, two ectopic pinpoint ostia in the bulbous urethra, and a blind membranous pouch. Incision of the bulbous ostia released abundant proteinaceous material, relieved the obstruction, and improved postoperative uroflowmetry. Syringocele should be considered in boys with unexplained infravesical obstruction.