[Imperforate syringocele of the Cowper's glands laparoscopic treatment]. / Siringocele imperforado de las glándulas de Cowper. Tratamiento por vía laparoscópica.

OBJECTIVES: The authors present a clinical report of an imperforate syringocele diagnosed on a male patient and treated by laparoscopic surgery. MATERIAL AND METHODS: A forty-four year old patient attends the emergency room with acute urinary retention. With a former history of mild obstructive voiding symptoms, he presented, at rectal examination, a bump on the left rectal wall. This patient also underwent urethrocistoscopy, sonography and retrograde urethrography. To establish the diagnose, Computerized Tomography (CT) scan and MRI were used. RESULTS: The syringocele marsupialization by laparoscopic surgery, allowed the resolution of the clinical problem, with a good outcome. The patient was discharged 48 hours after surgery, with no need of a vesical catheter. A six month follow-up showed no recurrence. CONCLUSIONS: The syringocele is a rare deformity which usually is asymptomatic. Of acquired or congenital etiology, it can be classified in four different morphological types: simple, perforate, imperforate and ruptured. The most frequent treatment is the marsupialization of the syringocele by endoscopic surgery, leaving a broad opening of the cavity to the urethra. Some authors recommend an open surgery excision, specially in the presence of an abscess. The laparoscopic approach becomes a minimally invasive alternative with good therapeutically outcome. In the incidentally discovered asymptomatic patients, an expectant approach is the correct approach.

Siringocele imperforado de las glándulas de Cowper. Tratamiento por vía laparoscópica / Imperforate syringocele of the Cowper’s glands laparoscopic treatment

OBJETIVO: Los autores presentan el caso clínico de un siringocele imperforado, diagnosticado en un adulto y tratado por cirugía laparoscópica. MATERIAL Y MÉTODOS: Paciente de 44 años que acude al Servicio de Urgencia por retención urinaria aguda y antecedente de leves síntomas obstructivos del aparato urinario inferior. Presenta al toque rectal tumefacción de la pared rectal izquierda. El enfermo fue sometido a uretrocistoscopia, ecografía y uretrografía retrógrada. El diagnóstico se obtuvo conTomografía Computerizada y Resonancia Magnética Nuclear. RESULTADOS: La marsupialización del siringocele por vía laparoscópica permitió la resolución del cuadro clínico con buena evolución post-operatoria. El paciente tuvo alta hospitalaria a las 48 horas sin necesidad de sonda vesical. Tras seis meses de seguimiento se encuentra asintomático.CONCLUSIONES: El siringocele es una deformidad rara que habitualmente no provoca síntomas. Puede ser de etiología congénita o adquirida, clasificándose en tres tipos morfológicos: simple, imperforado, perforado o roto. El tratamiento más frecuentemente utilizado es la marsupialización por vía endoscópica dejando una abertura amplia de la cavidad para la uretra. Algunos autores recomiendan su escisión por cirugía abierta, especialmente cuando forma absceso. El abordaje laparoscópico constituye una alternativa mínimamente invasiva con buenos resultados. En los casos asintomáticos diagnosticados incidentalmente se debe optar por una actitud expectante

OBJECTIVES: The authors present a clinical report of an imperforate syringocele diagnosed on a male patientand treated by laparoscopic surgery. MATERIAL AND METHODS: A forty-four year old patient attends the emergency room with acute urinary retention. With a former history of mild obstructive voiding symptoms, he presented, at rectal examination, abump on the left rectal wall. This patient also underwent urethrocistoscopy, sonography and retrograde urethrography.To establish the diagnose, Computerized Tomography (CT) scan and MRI were used. RESULTS: The syringocele marsupialization by laparoscopic surgery, allowed the resolution of the clinical problem, with a good outcome. The patient was discharged 48 hours after surgery, with no need of a vesical catheter. A six month follow-up showed no recurrence. CONCLUSIONS: The syringocele is a rare deformity which usually is asymptomatic. Of acquired or congenitaletiology, it can be classified in four different morphological types: simple, perforate, imperforate and ruptured. The most frequent treatment is the marsupialization of the syringocele by endoscopic surgery, leaving a broad opening of the cavity to the urethra. Some authors recommend an open surgery excision, specially in the presence of an abscess. The laparoscopic approach becomes a minimally invasive alternative with good therapeutically outcome. In the incidentally discovered asymptomatic patients, an expectant approach is the correct approach