ABSTRACT
Cowper's syringocele is a rare but an under-diagnosed cystic dilation of the Cowper's ducts and is increasingly being recognized in the adult population. Recent literature suggests that syringoceles be classified based on the configuration of the duct's orifice to the urethra, either open or closed, as this also allows the clinical presentations of 2 syringoceles to be divided, albeit with some overlap. Usually post-void dribbling, hematuria, or urethral discharge indicate open syringocele, while obstructive symptoms are associated with closed syringoceles. As these symptoms are shared by many serious conditions, a working differential diagnosis is critical. Ultrasonography coupled with retro and ante grade urethrography usually suffices to diagnose syringocele, but supplementary procedures - such as cystourethroscopy, computed tomography scan, and magnetic resonance imaging - can prove useful. Conservative observation is first recommended, but persistent symptoms are usually treated with endoscopic marsupialization unless contraindicated. Upon reviewing the literature, this paper addresses the clinical anatomy, classification, presentation, diagnosis, and treatment of syringoceles in further detail.
Subject(s)
Adult , Child , Humans , Male , Bulbourethral Glands , Cysts/diagnosis , Genital Diseases, Male/diagnosis , Cysts/therapy , Dilatation, Pathologic/classification , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/therapy , Genital Diseases, Male/therapyABSTRACT
Pielectasia es la dilatación leve de la pelvis renal, con o sin dilatación de los cálices, alteración que pude ser detectada mediante ultrasonografía prenatal. La pielectasia se detecta en 2,9 por ciento de los fetos evaluados (rango: 2-7 por ciento). El criterio más utilizado para el diagnóstico es la medición del diámetro antero-posterior de la pelvis renal mayor a 4 mm antes de las 33 semanas y mayor a 7 mm después de las 33 semanas. Se recomienda clasificar a las pielectasias de acuerdo al grado de dilatación en leve (<10 mm), moderada (entre 11 y 15 mm) y severa (>15 mm). El manejo antenatal es conservador. La evaluación postnatal se basa en confirmar la dilatación, determinar la etiología y descartar obstrucción.