Masson J C, Suhler A, Garbay B
J Urol Nephrol (Paris). 1979 Jul-Aug;85(7-8):497-511.
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.
作者从11个个人病例研究出发,对考珀氏腺引发的问题进行了全面综述。考珀氏腺作为附属性腺,由位于尿道球后方、尿生殖膈水平两侧的主腺以及位于尿道球海绵体内部的附属腺组成。主腺通过长导管(数厘米长)引流,这些导管经旁正中孔排入尿道球部。这些导管在尿道开口处融合为单一导管的情况虽罕见,但可能导致梗阻。这些导管可能出现直径从几毫米到6厘米不等的囊性扩张。这些囊肿很少是由慢性炎症性尿道炎导致的终末导管梗阻引起的。大多数情况下它们是先天性的。在附属腺水平形成的囊肿通常具有梗阻性,而在主腺水平形成的囊肿则更倾向于会阴扩张。这种特殊病理情况的指示性体征并不具有特异性(脓尿、血尿、遗尿、已知的尿道狭窄、尿频伴排尿困难、排尿后尿道滴沥伴会阴疼痛)。排尿尿道造影检查(最佳检查方法)显示:——要么是尿道腹侧出现的囊性扩张,表现为腔隙;——要么是排泄管扩张腔的造影剂充盈,这些扩张腔已自发破裂或经内镜操作打开。这些腔的造影剂充盈常常导致对“尿道憩室”或“尿道不完全重复”的错误解读,然而它们的基本特征有两个方面:它们相对于尿道呈前后方向排列,并向后背离尿道;它们在至少部分行程中具有管道型形态。