Cowper Gland Disorders
The two bulbourethral glands are about the size of a pea and lie in the pelvic floor near the base of the penis. They secrete a clear slippery liquid through the ducts that surface in the urethra at the base of the penis. This liquid makes up the majority of pre-ejaculate fluid that cleanses and neutralizes urine left in the urethra. Pre-ejaculate can also serve as a lubricant for the tip of the penis during intercourse.
Disorders of the bulbourethral gland and ducts are often overlooked since symptoms can mimic other disorders of the reproductive tract.
A bulbourethral syringocele is a dilation of the duct that leads from the bulbourethral gland to the urethra (the white cord shown in the illustration on the next page). The duct may be open or closed. “Open” syringoceles have the duct emptying into the urethra and symptoms include a urethra discharge, dribbling after urination, urinary tract infections, perineal pain, and/or hematuria (blood in the urine). “Closed” syringoceles on the other hand occur when there is dilation in the duct but the duct is shut off from the urethra. Symptoms can include difficulties emptying urine, painful urination, inability to urinate, and/or perineal pain. However, many men with bulbourethral syringoceles often have no symptoms explaining why this disorder is often overlooked.
Treatment is often unnecessary as many syringoceles resolve or get better on their own. Simply treating other associated infections such as prostatitis or a urinary tract infection can also treat a syringocele. For men who have severe symptoms or symptoms that don’t go away on their own, various surgical procedures can be performed to resolve the syringocele.
Cowperitis is an inflammation of the bulbourethral gland. It can be acute (short term) or chronic (long term).
In acute cowperitis, men often don’t feel well overall and can have a fever. Pain is often felt in the perenium. Men often complain of feeling like they have to have a bowel movement frequently and urgently. Bowel movements can often be quite painful. Having a rectal exam is often very painful in men with acute copweritits.
Chronic cowperitis on the other hand is often not as painful, but symptoms last for longer periods of time. Oftentimes, chronic cowperitis is caused by a syringocele which allows bacteria to migrate up the duct and infect the gland itself.
Treatments can include antibiotics and/or correcting any structural abnormalities such as a syringocele.
COWPER'S GLAND STONES
The bulbourethral glands can also get stones of calcium and other minerals, much like a kidney stone. This usually only happens in older men when fluid resides in the duct and gland for too long and begins to crystalize. Treatment is often unnecessary, but larger stones may be surgically removed.
COWPER'S GLAND CANCER
Cancer of the bulbourethral glands is fairly rare. Symptoms may include a bloody discharge from the penis that isn’t associated with lab tests or symptoms that would indicate another more common cancer such as prostate cancer. Any bloody discharge from the penis should always be an indication that a man should see his healthcare provider.
[i] Melquist J, et. al. Current diagnosis and management of syringocele: a review. Int Braz J Urol. 2010 Jan-Feb;36(1):3-9.
[ii] Chughtai B, et. al. A neglected gland: a review of Cowper’s gland. Internal Journal of Andrology, Vol 28 (2), Apr 2005, 74-77.