Urethral syringocele: a rare cause of recurrent urinary tract infections

A man in his early 30s presented with a 3 week history of dysuria, urinary frequency, urethral discharge and cloudy urine despite two courses of antibiotics. He subsequently developed a tender perineal swelling. His urine flow rate was normal and on flexible cystoscopy, a cystic bulging area distal to the external urethral sphincter was visualised. A pelvic MRI scan revealed a cystic abnormality at the bulb in the midline measuring 3.5×2.1×1.9 cm, consistent with a syringocele of the bulb. The patient underwent endoscopic laser deroofing of the syringocele. Syringocele is a rare abnormality in young male patients and should be considered as part of the differential for those presenting with recurrent urinary tract infections or obstructive urinary symptoms. Endoscopic laser deroofing of the syringocele seems to be an effective way to manage this condition in adults, resulting in radiological and symptomatic resolution of the syringocele without any complications in this case.