Name of the Procedure:

Excision of Bulbourethral Gland (Cowper's Gland)

Summary

The excision of the bulbourethral gland, also known as Cowper's gland, is a surgical procedure where the doctor removes one or both of these glands located at the base of the penis. These glands are responsible for producing a fluid that is a part of the male pre-ejaculate.

Purpose

The procedure is primarily performed to treat conditions such as chronic inflammation or infection of the Cowper's gland (Cowperitis), blockages, or cysts. The goal is to alleviate pain, prevent recurrent infections, and resolve other symptoms associated with gland dysfunction.

Indications

Patients who might need this procedure typically experience:

• Persistent pain or discomfort in the perineal area
• Recurrent urinary tract infections (UTIs) or bulbourethral gland infections
• Presence of cysts or abscesses that do not respond to other treatments
• Obstruction of the urinary flow due to enlargement of the gland

Preparation

Patients are usually advised to:

• Follow fasting instructions (typically 6-8 hours before surgery)
• Discuss any current medications with their doctor, as some might need to be adjusted or temporarily halted
• Undergo required diagnostic tests like imaging studies (ultrasound or MRI) to assess the gland and its surrounding structures

Procedure Description

1. Anesthesia: The patient is given either general or regional anesthesia to induce sleep or numb the surgical area.
2. Incision: A small incision is made in the perineal area.
3. Excision: The surgeon locates the bulbourethral gland and carefully excises it.
4. Closure: The incision is then closed with sutures, and a bandage is applied.

Special surgical instruments are used throughout the procedure, and a catheter may be placed temporarily to drain urine.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This surgery is usually conducted in a hospital or an outpatient surgical center.

Personnel

• Urologist or specialized surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

Potential risks and complications include:

• Bleeding or infection at the surgical site
• Temporary or persistent pain in the perineal area
• Scar tissue formation
• Potential impact on urinary function
• Reaction to anesthesia

Benefits

The primary benefits include relief from pain, reduced risk of recurrent infections, and improved quality of life. These benefits are usually noticed within a few weeks post-surgery.

Recovery

Post-procedure care includes:

• Instructions to avoid strenuous activity or heavy lifting for at least 2-4 weeks
• Pain management with prescribed medications
• Keeping the incision area clean and dry
• Follow-up appointments to monitor healing and any complications

Most patients can resume normal activities within a few weeks, although some restrictions may apply until full recovery.

Alternatives

Alternative treatments may include:

• Antibiotic therapy for infections
• Drainage of cysts or abscesses
• Less invasive procedures such as aspiration or endoscopic removal, though these might be less effective in certain cases

Each alternative has its pros and cons and should be discussed with a healthcare provider.

Patient Experience

Patients might experience discomfort and soreness in the perineal area post-procedure. Pain is typically managed with medications, and most discomfort subsides gradually within a few days to weeks. Proper post-operative care and adherence to recovery guidelines can enhance comfort and promote faster healing.