[Cowper's canals and glands. Pathological manifestations and radiologic aspects]

Abstract

From 11 personal case studies, the authors conduct a general review of the problems raised by Cowper's glands. Cowper's glands, accessory sexual glands, are made up of main glands situated behind and on either side of the bulbar urethra right at the level of the urolgenital diaphragm and of accessory glands situated in the thickness of the bulbar spongy body. The main glands are drained by long canals (several centimeters in length) which empty into the bulbar urethra by paramedian orifices. The fusion of these canals into one single canal at the urethral opening, although rare, could lead to obstruction. These canals can be the site of cystic dilatation ranging from a few millimeters to as much as 6 cm in diameter. These cysts are rarely due to terminal canal obstruction as the result of chronic inflammatory urethritis. Most often they are congenital. The cysts which develop at the level of the accessory glands are usually obstructive while those which develop at the level of the main glands rather have a perineal expansion. The indicative signs of this particular pathology are not specific (pyuria, hematuria, enureis, known urethral stenosis, dysuria with pollakuria, perineal pain with post voiding urethral dripping). Voiding urethrography investigation (the best) shows: --either cystic dilatation seen as a lacuna on the ventral aspect of the urethra, --or opacification of the dilated cavities of the exretory canals which have been spontaneously broken or opened by endoscopic manoeuvres. The opacification of these cavities leads often to the erroneous interpretation of "diverticula" of "incomplete duplication of the urethra" and yet their essential characteristic is twofold: they are oriented in an anterior-posterior direction with respect to the urethra and lead back and away from it; they have a canal type of morphology for at least part of their course.