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Zinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed with ZS following a 2-month history of urinary frequency, hesitancy, dysuria, and painful ejaculation. Physical examination revealed a left lower abdominal mass, and imaging confirmed the classic findings of ZS, including unilateral renal agenesis, an enlarged seminal vesicle cyst, and an ectopic ureter. Conservative treatment with tamsulosin initially improved symptoms, but due to the cyst's large size and the risk of complications, laparoscopic excision was recommended for definitive management. ZS is often diagnosed late due to nonspecific symptoms, with an average diagnosis age of 29.35 years. MRI is the gold standard for diagnosis, revealing seminal vesicle cysts, renal agenesis, and ejaculatory duct obstruction. Conservative management is reserved for asymptomatic cases, while symptomatic patients benefit from surgical intervention. This case emphasizes the importance of timely imaging, particularly in patients with nonspecific lower urinary tract symptoms, and highlights the role of tamsulosin as an effective interim therapy before definitive surgical treatment. The case underscores the need for clear diagnostic criteria and treatment pathways to improve outcomes in this rare condition, which can lead to infertility if not managed appropriately.

Over 200 cases of seminal vesicle cysts linked to ipsilateral renal agenesis have been reported in the literature, indicating Zinner syndrome. This condition occurs when the ureteric buds fail to meet the metanephros, leading to cystic dilatation in the ipsilateral seminal vesicle along with unilateral renal agenesis. Here, we are discussing a 17-year-old boy who presented with lower urinary tract symptoms predominantly flow symptoms, was evaluated thoroughly, and robotic surgery was selected as the best minimally invasive treatment.

Zinner syndrome is a rare congenital urological entity, secondary to an alteration in embryogenesis between 4th and 13th weeks of gestation, specifically because of abnormalities in the development of the distal mesonephric duct. It is characterized by the triad of unilateral renal agenesis, cystic dilatation of the ipsilateral seminal vesicle and ipsilateral ejaculatory duct obstruction. The aim of this article is to provide the reader with all the necessary information to be able to suspect the presence of this syndrome, reviewing its physiopathology, clinical manifestations and the imaging techniques that enable its diagnosis, emphasizing those radiological findings by MRI that should lead us to think about it. This work is illustrated with representative radiological images of cases belonging to our institution, including patients with different variants of Zinner syndrome. We also include an overview of the embryology of the male urogenital system, to remember the role of the mesonephric duct and the ureteral bud in the formation of the different urogenital structures, as well as a differential diagnosis that allows us to differentiate seminal vesicle cysts from other pelvic cystic lesions. [ABSTRACT FROM AUTHOR]

Anomalies of the mesonephric duct are associated with a combination of renal agenesis/dysgenesis, ejaculatory duct obstruction, and seminal vesical cyst, called Zinner syndrome. We present a case of this rare syndrome in a young male patient, who initially presented with urinary symptoms. The relevant embryology and diagnostic modalities are discussed. [ABSTRACT FROM AUTHOR]

Zinner Syndrome (ZS) is a rare congenital disorder characterized by seminal vesicle cysts (SVC) and ipsilateral upper urinary tract abnormalities, mainly due to developmental anomalies of the mesonephric duct. This series highlights our institutional experience with pediatric ZS, with a review of the current literature offering insights into its etiopathogenesis in early childhood. A retrospective case review of pediatric ZS diagnosed at our institution from 2019 to 2023, alongside a comprehensive literature review. Four pediatric ZS cases were identified, a neonate, an infant and two older (pre-pubertal) children, presenting with recurrent epididymo-orchitis and/or UTIs. The two older children had duplex systems, both undergoing curative upper moiety heminephrectomy; the infant underwent nephroureterectomy and the neonate is under observation, asymptomatic for past 18 months. When Zinner identified the link between unilateral renal agenesis and ipsilateral SVC in 1914, the condition's embryological basis was attributed to incorrect ureteric bud migration from the mesonephric duct, failing to stimulate the metanephros, leading to renal agenesis/dysplasia and this disruption was hypothesized to obstruct seminal vesicle drainage, causing cyst formation. Another theory suggests anomalous development of the distal mesonephric duct leading to ejaculatory duct atresia/stenosis which results in cystic enlargement of the seminal vesicles which, in turn, leads to aberrant ureteral budding, resulting in renal malformations. It is our belief that the SVCs, that are typically problematic in adolescence/adulthood due to secretion accumulation, sometimes manifest in childhood due to urinary reflux into the seminal vesicles, leading to epididymo-orchitis or UTIs. This contrasts with adult pathogenesis, where ejaculatory duct obstruction predominates. Hence, treatment leans towards a conservative approach for asymptomatic cases, with surgery reserved for symptomatic children. The scope of this case series is limited by the rare nature of ZS in prepubertal children (41 published cases in English literature), preventing a comprehensive understanding of its untreated natural history and restricting the formulation of generalized recommendations. The variability in presentation of ZS in children necessitates a tailored approach. Unlike adults, where ejaculatory duct obstruction is the common cause, pediatric ZS symptoms mainly stem from urethra-cystic reflux, leading to recurrent infections. [ABSTRACT FROM AUTHOR]

BackgroundSeminal vesicle cysts (SVCs) are rare benign diseases in men and are commonly asymptomatic. Giant SVCs with complications there are no standard treatments for SVCs, however surgical intervention is required for giant SVCs accompanied with complications.Case summaryWe present one case of a 49-year-old male patient diagnosed with giant SVC. Chief complaint of this patient was persistent gross hematuria for 1 week. Both a computed tomography (CT) and magnetic resonance imaging (MRI) scans indicated the presence of a cystic mass in left seminal vesicle with hemorrhage, of which the maximum diameter is 6.5 cm. Additionally, Giant SVC squeezed the prostate and lower ureter, leading to the dilatation of the left upper ureter and hydronephrosis. After a thorough preoperative evaluation, a laparoscopic resection of SVC and left ureteral stenting were performed. The subsequent pathological analysis identified a seminal vesicle cyst inflammatory infiltration. Postoperative follow-up indicated no abnormalities in left seminal vesicle.ConclusionLaparoscopic surgery is recommended for giant SVCs with complications.

Zinner syndrome is a rare congenital malformation of the Wolffian duct with seminal vesicle cyst, ipsilateral renal agenesis and ejaculatory duct obstruction, seen in less than 0.002 % of the male population. An increased awareness among clinicians, urologists, and radiologists is essential, as early diagnosis and management can impact fertility outcomes. This review aims to explain and illustrate Zinner syndrome through imaging case studies. Emphasis is made on considering Zinner syndrome in the differential diagnosis of young males with pelvic pain and renal agenesis, highlighting the importance of radiological evaluation for the management of this uncommon yet clinically significant condition.

Over 200 cases of seminal vesicle cysts linked to ipsilateral renal agenesis have been reported in the literature, indicating Zinner syndrome. This condition occurs when the ureteric buds fail to meet the metanephros, leading to cystic dilatation in the ipsilateral seminal vesicle along with unilateral renal agenesis. Here, we are discussing a 17-year-old boy who presented with lower urinary tract symptoms predominantly flow symptoms, was evaluated thoroughly, and robotic surgery was selected as the best minimally invasive treatment. Keywords:Zinner syndrome, general urology, radiology, seminal vesicle cyst: [ABSTRACT FROM AUTHOR]

Introduction This report describes a case with an ectopic ejaculatory duct opening into the bladder trigone in Zinner syndrome, congenital unilateral renal agenesis, and an ipsilateral seminal vesicle cyst. Case presentation The patient was identified when no left kidney was detected in the fetal period. Abdominal ultrasonography and pelvic plain MRI at 6 months old revealed a 10‐mm cystic lesion on the dorsal aspect of the bladder. Cysto‐urethroscopy at 1 year old revealed a rather short posterior urethra and right and left inferior crests extending from the posterior urethra beyond the bladder neck. The ejaculatory duct opening was identified on the bladder trigone. Conclusion Anatomical abnormality of the ejaculatory duct may represent a cause of infertility and ejaculatory dysfunction in Zinner syndrome. Endoscopic evaluation should be performed for this rare anomaly, even in children.

Zinner syndrome comprises a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction, which can be accompanied by additional abnormalities of the genitourinary tract in some cases. Patients may be asymptomatic or present with urinary, reproductive, and/or local pain symptoms. Diagnosis is most commonly achieved via MRI. Here, we present the case of an 18-year-old male previously diagnosed with unilateral renal agenesis, who presented with testicular and penile pain, along with urinary urgency and frequency. MRI of the abdomen and pelvis revealed all three components of Zinner syndrome as well as an ectopic ureter emptying into the seminal vesicle. Our case adds to the existing limited literature on this rare syndrome and broadens the understanding of how this syndrome can present both clinically and radiologically.

Objective To investigate the key issues of clinical diagnosis and treatment of Zinner syndrome and reduce the misdiagnosis rate. Methods Clinical data of 1 case of Zinner syndrome were retrospectively analyzed. Zinner syndrome cases presenting hematuria， frequent urination and dysuria as initial manifestations were retrieved from PubMed， CNKI， Wanfang Data and Chongqing VIP until November 2022 by using the searching words of Zinner syndrome， renal agenesis and seminal vesicle cyst. Clinical characteristics， developmental characteristics and treatment methods were summarized. Results The 46-year-old male patient was admitted to the hospital because of “bladder space-occupying lesion for more than 8 years， hematuria with dysuria for 1 week”， and was diagnosed with Zinner syndrome by imaging examination. He successfully underwent “transurethral cystoscopy + transrectal pelvic mass puncture biopsy”， and was discharged from the hospital at postoperative 2 d. The patient was advised to continually receive anti-infection treatment after discharge. According to literature review， 16 cases of Zinner syndrome presenting with hematuria， dysuria and other urinary symptoms as the first manifestations were collected. All patients developed abnormalities in the urinary system by imaging examination. Surgical resection and puncture biopsy were the main treatment methods. Among 8 patients receiving follow-up， 7 cases did not recur， and 1 suspected recurrent case underwent puncture biopsy. Conclusions Zinner syndrome is mainly manifested with imaging characteristics of unilateral seminal vesicle cyst， ipsilateral renal agenesis and ipsilateral ejaculatory duct obstruction triad. Ultrasound， CT scan， and MRI are important diagnostic tools for Zinner syndrome. Laparoscopic seminal vesicle cystectomy can reduce the risk of recurrence.

Copyright of Journal of New Medicine is the property of Sun Yat Sen University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This is the case of a 45-year-old male who presented with dysuria and gross hematuria. Ultrasonography and computed tomography revealed an enormous pelvic cystic lesion and a right nephromegaly but an invisible left kidney. Using the imaging findings, the patient was diagnosed with Zinner syndrome. Transperitoneal laparoscopic excision of the cyst was performed for symptom relief. At post-treatment, the symptoms disappeared, and sexual function remained. Seminal vesicle cysts have been commonly reported in previous studies but rarely in this case. Furthermore, most previous studies have documented surgical excision of

Abstract Background Zinner syndrome is a rare Wolffian duct anomaly presenting as a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. The condition is due to a developmental anomaly leading to malformation of the mesonephric duct. Magnetic resonance imaging is considered to be the gold standard for the diagnosis of Zinner syndrome. Due to the limited number of cases reported in the literature, the associations of Zinner syndrome are not well established. Case presentation In this case report, we are presenting a case of a 38-year-old male with dysuria, intermittent pain in the scrotum and lower abdomen and painful ejaculation for the past six months. Imaging findings led to the diagnosis of Zinner syndrome, with unilateral testicular agenesis and an aberrant course of the left common iliac artery. Conclusions Apart from the known associations of Zinner syndrome, testicular agenesis in a patient with Zinner syndrome has not been reported in the literature and is an important addition to the limited literature available.

A triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction has been called Zinner syndrome since its first description in 1914 by Zinner. It is a very rare congenital abnormality of the male genitourinary tract due to abnormal embryologic development of the Wolffian ducts. There have been several case reports from different parts of the world about the clinical and imaging findings of these anomaly. In this case report, we present the first case report of Zinner syndrome in a 28-year-old male Ethiopian patient.

Zinner's syndrome is a rare developmental anomaly of Wolffian duct, comprising a triad of seminal vesicle cyst, ipsilateral renal agenesis and ejaculatory duct obstruction, first described by Zinner in 1914. Several aberrations have been reported like renal dysplasia, ectopic ureteric orifice in one of the derivatives of Wolffian duct. Usually it presents in second to fourth decade of life with symptoms of urinary bladder irritation/obstruction, cyst distension, ejaculatory duct obstruction. The diagnosis is principally based on imaging studies, usually confirmed by MRI. Treatment is based upon the persistent symptoms or complications related to it. Excision of cyst is gold standard.

Zinner’s syndrome (ZS) is a rare congenital malformation due to abnormal development of the urogenital tract. It is characterized by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. Cases are rarely reported in China since the incidence of the disease is low. Symptoms also vary widely among patients and its etiology is unclear. In this article, we described two patients with totally different cinicopathological and genetic features based on exon sequencing.

Zinner's syndrome is a very rare congenital condition characterised by seminal vesicle cyst, obstruction of the ejaculatory duct and ipsilateral renal agenesis. Here, we present a 25-year- old young short-statured male presented with left lower abdominal colicky pain. MRI abdomen showed the absence of the left kidney with a seminal vesicle cyst on the left side. The cyst in question was laparoscopically de-roofed. A second case is a 16-years-old young male who presented with intermittent lower abdominal pain. MRI abdomen showed seminal vesicle cyst with ipsilateral absent kidney which is managed conservatively with medication. Level of evidence : Not applicable [ABSTRACT FROM AUTHOR]

Abstract Background Zinner's syndrome is a mesonephric duct anomaly characterized by unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction due to insult occurred at urogenital tract embryogenesis during the first trimester. In the third and fourth decades of life, it is frequently diagnosed when patients begin to be symptomatic, such as lower urinary tract symptoms, infertility and painful ejaculation. Case presentation Herein we illustrate case review including five patients diagnosed as Zinner’s syndrome, three of them complaining from infertility; however, the remaining two cases were fertile and incidentally diagnosed. Conclusions Radiological investigations play significant role in the diagnostic and management processes including US, CT and MRI for detecting ipsilateral renal agenesis and unilateral seminal vesicles dilatation, but evaluation of ejaculatory duct can be done only by MRI and transrectal ultrasound; however, the latter may be sometimes nonconclusive or intolerable by patients, so MRI is considered the golden modality with its high capability to assess the lower male genital tract which played a significant role in our case series starting with detection of the presence or absence of the ejaculatory duct obstruction as well as the high delineation of the origin and nature the seminal vesicle cyst including also its size and content and finally by detection of the communication between ureteral bud and the seminal vesicles cystic dilatation.

IntroductionZinner syndrome (ZS) is a rare condition characterized by a triad of seminal vesicle cyst (SVC), ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. The diagnosis is often delayed due to non-specific symptoms, such as lower urinary tract symptoms and infertility, typically appearing in the second and third decades of life.Case presentationWe present the first published case of ZS in Palestine, involving a 53-year-old male patient who sought medical attention for right-sided hernia repair. Pre-operative imaging revealed a combination of findings, including a solitary left kidney with cysts, mild hydronephrosis, an enlarged prostate, suspicious soft tissue density, and abnormal lymph nodes. The diagnosis of ZS was confirmed through an abdominal ultrasound, identifying a dilated seminal vesicle and completing the criteria of ZS.DiscussionThe typical for ZS is to present in late second decade of life with nonspecific urogenital symptoms and infertility, However, our patient’s incidental diagnosis during the preoperative evaluation of incisional hernia in a relatively old age with no previous complaints, the identification of a high aortic bifurcation at the level of the left kidney and a double Inferior Vena Cava (IVC) in this case of ZS represents novel and distinctive findings not commonly reported in previous cases.ConclusionOur patient’s presentation and findings expand our understanding of the anatomical variations associated with ZS. This case report contributes to the advancement of knowledge in the field of ZS and provides valuable insights for future clinical management and research investigations.

Background: Zinner syndrome is a rare Wolffian duct anomaly presenting as a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. The condition is due to a developmental anomaly leading to malformation of the mesonephric duct. Magnetic resonance imaging is considered to be the gold standard for the diagnosis of Zinner syndrome. Due to the limited number of cases reported in the literature, the associations of Zinner syndrome are not well established. Case presentation: In this case report, we are presenting a case of a 38-year-old male with dysuria, intermittent pain in the scrotum and lower abdomen and painful ejaculation for the past six months. Imaging findings led to the diagnosis of Zinner syndrome, with unilateral testicular agenesis and an aberrant course of the left common iliac artery. Conclusions: Apart from the known associations of Zinner syndrome, testicular agenesis in a patient with Zinner syndrome has not been reported in the literature and is an important addition to the limited literature available. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to report our experience on the management of seminal vesicle cyst which is an exceedingly rare acquired or congenital pathology. Materials and Methods: A retrospective chart review was conducted on seven patients diagnosed with seminal vesicle cyst between March 2011 to March 2020. Patients’ complaints, fertility, physical signs, diagnostic tests or intervention and the obtained findings, surgical intervention, duration of follow-up period, complications, recurrence and histologic examination of the cysts wall were evaluated in patients included. Results: Seven male patients, mean aged 36.29±13.45, IPSS 13.57±4.89, Qmax:21.77±3.42ml/s with seminal vesicle cysts were identified. The patients’ complaints included lower abdominal pain in one patient with giant seminal vesicle cyst and perineal pain, storage lower urinary tract symptoms in six patient. Five patients were fertile and spermiogram was within normal ranges, two patients were infertile. Six patients have ipsilateral renal agenesia. One asymptomatic patient and three patients with storage lower urinary tract sympmtoms followed without intervention. Two infertile patients were operated with transurethral resection. Seminal vesicle cyst >12 cm are evaluated as giant cysts and operated with open excision. Neither complications nor recurrences were observed. Histopathologic examination of the samples were reported to be compatible with seminal vesicle cyst. The median follow–up period was 96 months. Conclusion: The open surgical approach might be considered the definitive form of treatment for giant cysts. Although small asymptomatic seminal vesical cyst can be followed without intervention, the symptomatic cyst protruding to bladder can be managed by transurethral route.

Ke Ding,1 Wei Wang,2 Ye Kang,3 Lei Zhang,2 Shuo Tan,1 Zhengyan Tang1 1The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2The Department of Urology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3The Department of Urology, Hunan Provincial People’s Hospital, Hunan Normal University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Shuo Tan; Zhengyan Tang, Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, Hunan, 410008, People’s Republic of China, Tel +8615273133018 ; +8613507318268, Email tanshuo@csu.edu.cn; xytzyan@163.comBackground: To illustrate the transperitoneal laparoscopic unroofing (TLU) and compare the efficacy and safety of TLU to fenestration under seminal vesiculoscopy (FUSV) in treating symptomatic seminal vesicle cyst (SVC).Methods: We retrospectively reviewed all patients with symptomatic SVC who underwent TLU or FUSV between 2008 and 2020 at 3 institutions in Hunan. The two groups were evaluated with reference to radiological failure-free survival (R-FFS), fertility outcome, symptoms, and complications at a median 33.5-month follow-up.Results: Of the 98 males, 58 (59.2%) received TLU, and 40 (40.8%) underwent FUSV. Baseline characteristics were comparable. Semen analysis, prostatitis-like symptoms, and the maximum diameter of cyst were partially improved after both surgeries at 12-month follow-up. The TLU groups suggested a higher incidence rate of fertility for SVC patients with comorbid infertility compared with the FUSV group (82.4% vs 70.3%, p = 0.041), as well as better R-FFS of cysts at five-year follow-up (Log rank test, p = 0.021). In addition, the number of patients with NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom Index) scores higher than 15 decreased more significantly after TLU (p = 0.004). Except for hematospermia within 3 months, no significant difference in adverse events was observed in the two groups during the long-term follow-up.Conclusion: TLU was superior for patients with large and symptomatic SVC to FUSV, with more relieved symptoms, better R-FFS of cysts and fertility outcomes.Registration Number of Clinical Trial: ChiCTR2100053850 in Chinese Clinical Trial Registry Platform (ChiCTR).Keywords: seminal vesicle cyst, laparoscopic unroofing, seminal vesiculoscopy, radiological failure-free survival, male infertility

Background: Zinner syndrome (ZS), the association of congenital seminal vesicle cyst (SVC) and ipsilateral kidney anomalies, is rarely diagnosed in childhood. This study aimed to assess presentation, imaging findings, management, and outcome of pediatric ZS. Methods: Sixteen children with ZS were diagnosed and managed at our hospital from 2003 to 2021. We reviewed the medical records to collect data on initial symptoms, results of imaging studies, complications, operation, and follow-up. Results: Ultrasound was used in all 16 cases as initial diagnostic tool. Fourteen patients were asymptomatic at diagnosis: these were transferred from obstetricians or pediatricians for evaluation of the prenatally or postnatally detected ultrasonic kidney anomalies. SVCs were incidentally noted on ultrasonography. The other two cases initially presented with urinary tract infection (UTI). Kidney anomalies included multicystic dysplastic kidney in 3 and kidney agenesis in 13 patients. Eleven (68.7%) patients had ipsilateral ectopic ureters entering SVC. Four (36.4%) patients had a reflux from urethra into SVC (urethro-cystic reflux) on voiding cystourethrography. Ten (62.5%) patients remained asymptomatic over a mean of 58 months (range, 7–216 months), two patients developed lower urinary tract dysfunction, and five patients had UTIs. Two boys needed SVC removal, and SVC had disappeared in two patients after 2.5–4 years of follow-up. Conclusions: Unilateral kidney hypodysplasia with ectopic ureter inserting into the ipsilateral SVC is a characteristic sign for diagnosis of ZS. In our case series, ZS was mainly asymptomatic. Urethro-cystic reflux was associated with UTIs in young infants. SVC removal was rarely required. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

Background: Zinner's syndrome is a mesonephric duct anomaly characterized by unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction due to insult occurred at urogenital tract embryogenesis during the first trimester. In the third and fourth decades of life, it is frequently diagnosed when patients begin to be symptomatic, such as lower urinary tract symptoms, infertility and painful ejaculation. Case presentation: Herein we illustrate case review including five patients diagnosed as Zinner's syndrome, three of them complaining from infertility; however, the remaining two cases were fertile and incidentally diagnosed. Conclusions: Radiological investigations play significant role in the diagnostic and management processes including US, CT and MRI for detecting ipsilateral renal agenesis and unilateral seminal vesicles dilatation, but evaluation of ejaculatory duct can be done only by MRI and transrectal ultrasound; however, the latter may be sometimes nonconclusive or intolerable by patients, so MRI is considered the golden modality with its high capability to assess the lower male genital tract which played a significant role in our case series starting with detection of the presence or absence of the ejaculatory duct obstruction as well as the high delineation of the origin and nature the seminal vesicle cyst including also its size and content and finally by detection of the communication between ureteral bud and the seminal vesicles cystic dilatation. [ABSTRACT FROM AUTHOR]

A 16-year-old male presented with persistent abdominal pain for 2 weeks. Mild elevation of liver enzymes ALT and AST was observed. Abdominal ultrasound revealed a missing right kidney and a dense cystic mass near the bladder. CT scan confirmed right kidney agenesis and identified a 7.5 x 7.5 x 10 cm cystic mass extending from the bladder to the prostate. Due to fever and worsening pain, laparoscopic surgery was performed to remove the complicated seminal vesicle cyst. Purulent ejaculate was drained and the cystic mass was completely excised. The patient recovered well and liver enzyme levels returned to normal after 1 month. [ABSTRACT FROM AUTHOR]

Herein, we report a case of a large and complex seminal vesicle cyst causing urinary retention in a young patient with left renal agenesis, psychotic disorder, and deep venous thrombosis. Abdominal computed tomography showed left renal agenesis with associated incipient hydronephrosis of the right renal unit. Furthermore, the whole pelvis was occupied by a large, heterodense cyst (116×113×107 mm), with several adherent and small cystic lesions (39×70 mm), compressing the posterior bladder wall. Open surgical approach was performed, including bilateral vesiculectomy with resection of the vas deferentia, since these structures were closely adhering to the cystic wall, and there was no clear surgical plane between them. A brief review of the literature on the main surgical options and postoperative outcomes was also undertaken.

A rare triad of Wolffian duct anomaly known as Zinner syndrome includes unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. It is often diagnosed in third and fourth decades of life. Patient presents with dysuria, perineal pain, infertility and painful ejaculation. The aim of this case report is to show the importance of the radiological imaging on diagnosis of Zinner syndrome. MRI being the modality of the choice for the confirmation of the diagnosis is vital in further management of the syndrome.

Zinner syndrome is a rare congenital abnormality of the mesonephric (Wolffian) duct consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. The syndrome usually presents in the second or third decade of life mainly after the beginning of sexual activity and usually in the form of voiding manifestations. The main imaging modality is magnetic resonance imaging (MRI); however, usually suspected in transabdominal sonography, which may give initial clue to the diagnosis. Herein, we report a rare case of a 24 - year male with right renal agenesis with cystic pelvic mass diagnosed as Zinner syndrome via multimodality imaging.

Zinner syndrome refers to the triad of ipsilateral renal agenesis, seminal vesicle cysts, and ejaculatory duct obstruction. Ipsilateral renal agenesis may be associated with seminal vesicle cysts in 70% of cases, but a remnant ureteral bud has been shown to coexist in only 27% of these cases. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction, voiding, or ejaculatory difficulty, or pain. Symptomatic cases are very rare in the preadolescent age group. The uniqueness of our case report is that the patient is a 16-year-old male with suprapubic discomfort who was diagnosed with left seminal vesicle cyst (Zinner syndrome) and was successfully managed by laparoscopic resection. To our knowledge, none of the case reports were published in such age group.

Copyright of Urologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age.

Abstract Background Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal vesicle cysts, ejaculatory duct obstruction and renal agenesis. Patients can be either asymptomatic or symptomatic. Recently, minimally invasive surgical techniques have emerged, superseding traditional surgery for select symptomatic cases. Our case highlights the finding of a rare clinical syndrome that was incidentally detected during a routine mass screening of military recruits in the Greek Armed Forces. Case presentation Herein, we present a case of a 19-year-old male who reported having a solitary right kidney when examined in a military training center of Northern Greece. No additional clinical information was available; thus, referral to a tertiary urology department for further investigation ensued. Imaging studies, namely, computed tomography and magnetic resonance imaging, revealed left renal aplasia, multiple left seminal vesicle cysts, and ejaculatory duct obstruction. Laboratory values and urinalysis were within normal range. Semen analysis was significant for cryptozoospermia. Our patient remained asymptomatic during the entire hospitalization. Long-term follow-up was recommended. Nevertheless, he declined further investigation and sought treatment in a private practice setting. Conclusions This article aims to present the incidental diagnosis of a rare syndrome in a military setting. Population screening conducted in the armed forces permits the identification of undiagnosed diseases that warrant further investigation. To the best of our knowledge, this was the first report of Zinner syndrome in a military recruit and the second case cited of a Greek patient in the published literature. Regular follow-up is the key to timely intervention in conservatively managed cases.

• Zinner Syndrome is a congenital pathology due to an embryologic anomaly. • This embryologic defect leads to unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. • Complete excision of the seminal vesicle cyst is the only 100% effective treatment option for symptomatic patients. • Minimally invasive approach like laparoscopy or robotic assisted laparoscopy should be considered as the surgical gold standard. Zinner Syndrome is a congenital pathology due to an embryologic anomaly occurring between the 4th and 13th gestational week. This embryologic defect leads to unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Most of the time patients are asymptomatic and do not need any treatment but for symptomatic cases, only surgical removal of the cyst and seminal vesicle are 100% effective. The case presented here is that of a healthy 33-year old man with symptomatic right seminal vesicle cyst and ipsilateral renal agenesis. First a conservative approach was attempted but each time the symptoms ended up reappearing. We decided to use robot-assisted laparoscopy to completely resect the cyst and the right seminal vesicle. There was no postoperative complication and the patient's symptoms improved immediately. After a 6 months follow-up the patient remains completely asymptomatic. Complete excision of the seminal vesicle cyst is the only 100% effective treatment option for symptomatic patients with Zinner syndrome. Minimally invasive approaches like conventional laparoscopy or robotic assisted laparoscopy are safe and effective and should currently be considered as the surgical gold standard. [ABSTRACT FROM AUTHOR]

Herein, we report a case of a large and complex seminal vesicle cyst causing urinary retention in a young patient with left renal agenesis, psychotic disorder, and deep venous thrombosis. Abdominal computed tomography showed left renal agenesis with associated incipient hydronephrosis of the right renal unit. Furthermore, the whole pelvis was occupied by a large, heterodense cyst (116×113×107 mm), with several adherent and small cystic lesions (39×70 mm), compressing the posterior bladder wall. Open surgical approach was performed, including bilateral vesiculectomy with resection of the vas deferentia, since these structures were closely adhering to the cystic wall, and there was no clear surgical plane between them. A brief review of the literature on the main surgical options and postoperative outcomes was also undertaken. [ABSTRACT FROM AUTHOR]

A seminal vesicle cyst remains a very rare diagnosis. Though most seminal vesicle cysts in the pediatric population are congenital and associated with ipsilateral upper urinary tract anomalies. We present a unique case of a 16-year-old with a small seminal vesicle cyst with normal upper urinary tract anatomy. This cyst was associated with urethral inflammation and stricture within the bulbar urethra, it is likely that this individual had an acquired seminal vesicle cyst at an abnormally young age although it is possible the cyst became inflamed and induced the urethral stricture. Despite the fact that the cause of his urethral pathology is unknown, the patient had nearly complete resolution of lower urinary tract signs and symptoms by the time of his follow-up visits at 1 week and 1 month.

Zinner syndrome is a rare male genitourinary tract disorder associated with seminal vesicle cysts and ipsilateral renal agenesis. Clinical presentation often involves symptoms of the genitourinary tract. We present a case report of a young Saudi male, presenting with nonspecific symptoms of fatigue and malaise. Ultrasound visualized a massive seminal vesicle cyst associated with ipsilateral renal agenesis. The cyst was managed using a laparoscopic technique without any immediate complications and an uneventful postoperative period.

Introduction: Zinner syndrome is a rare developmental anomaly of the Wolffian (mesonephric) duct which is characterized by a triad of obstruction of the ejaculatory duct, the ipsilateral seminal vesicle cyst, and the ipsilateral renal agenesis. Usually is totally asymptomatic, however it can also determine symptoms such as lower urinary tract symptoms, perineal pain, ejaculatory disorders such as painful ejaculation or hematospermia, and infertility. Case report: We present a case of a 51 years old men with a 3-year history of lower urinary tract symptoms, perineal pain, obstructed defecation, recurrent urinary tract infections and infertility. CT scan showed a voluminous cystic neoformation of the left seminal vesicle, hypoplasia of the left kidney and ipsilateral ureteronephrosis. The mass was removed using laparoscopic “en block” seminal vesiculectomy with associated ipsilateral nephroureterectomy. No post-operative complications occurred. At 2-month post-operative control the patient reported an improvement of urinary and rectal symptoms.

Zinner syndrome refers to the triad of ipsilateral renal agenesis, seminal vesicle cysts, and ejaculatory duct obstruction. Ipsilateral renal agenesis may be associated with seminal vesicle cysts in 70% of cases, but a remnant ureteral bud has been shown to coexist in only 27% of these cases. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction, voiding, or ejaculatory difficulty, or pain. Symptomatic cases are very rare in the preadolescent age group. The uniqueness of our case report is that the patient is a 16-year-old male with suprapubic discomfort who was diagnosed with left seminal vesicle cyst (Zinner syndrome) and was successfully managed by laparoscopic resection. To our knowledge, none of the case reports were published in such age group. [ABSTRACT FROM AUTHOR]

We present a case of a healthy 43-year-old man who experienced right lower abdominal mass with gastrointestinal upset for 6 months. A series of imaging studies revealed a large lobulated cyst in the right pelvis and retroperitoneum. Because of the persistent symptom, surgical intervention was performed to remove the cystic lesion. The final pathology report demonstrated a large seminal vesicle cyst with agenesis of kidney. It is compatible with the diagnosis of Zinner's syndrome. However, right lower abdominal mass is a rare manifestation of this syndrome. This case reminds us a unique differential diagnosis of a right lower abdominal mass.

Objectives: We reviewed the clinical presentation and approach for the treatment of symptomatic seminal vesicle cyst associated with ipsilateral renal agenesis while presenting our experience with a series of 5 patients treated with minimally invasive surgery for Zinner syndrome. Materials and Methods: Between the years 2008 and 2016, we operated on 5 patients who presented with symptomatic seminal vesicle cyst and ipsilateral renal agenesis. Patients' charts and medical records were reviewed and compared with past published minimally invasive series. Results: Four patients were treated in a laparoscopic approach and one was treated with robotic-assisted seminal vesicle cyst excision. In all cases, the cystic complex was drained and excised with marsupialization of the remaining cyst walls to prevent cystic recurrence. The mean operating time was 3: 47 h and mean hospitalization time was 7 days (4-14). The mean follow-up period was 3.2 years (range 1.7-4.8 years). All patients reported a resolution of symptoms during postoperative follow-up. Conclusions: Seminal vesicle cyst with ipsilateral renal agenesis should be suspected in young male patients presenting with pelvic cystic masses. Treatment is reserved for symptomatic patients and the preferred approach is minimally invasive surgery. This approach is feasible and effective while providing advantages both for the patient and the surgeon. [ABSTRACT FROM AUTHOR]