A rare case of Zinner syndrome: Triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction

Zinner syndrome is a developmental anomaly of the urogenital tract. This condition is defined by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. The syndrome is due to malformation of the mesonephric duct during embryogenesis. The condition used to be rare but is now frequently encountered due to the advent of MRI and CT. MRI confirms the diagnosis by revealing the seminal vesicle cyst and its contents, and the ejaculatory duct obstruction, while CT confirms renal agenesis. We report the case of a young patient with Zinner syndrome.

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AN UNUSUAL CASE OF BLADDER OUTLET OBSTRUCTION “ZINNER’ SYNDROME”- TRIAD OF SEMINAL VESICLE CYST, IPSILATERAL RENAL AGENESIS AND EJACULATORY DUCT OBSTRUCTION- A CASE REPORT

World Journal of Pharmacy and Pharmaceutical Sciences ◽

10.20959/wjpps20179-10031 ◽

2017 ◽

pp. 1329-1332

Author(s):

Prof. Joseph Philipraj

Keyword(s):

Case Report ◽

Seminal Vesicle ◽

Bladder Outlet Obstruction ◽

Unusual Case ◽

Renal Agenesis ◽

Ejaculatory Duct ◽

Outlet Obstruction ◽

Duct Obstruction ◽

Seminal Vesicle Cyst ◽

Ejaculatory Duct Obstruction

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A Triad of Unilateral Renal Dysgenesis with Ipsilateral Seminal Vesical and Ejaculatory Duct Obstruction: An Uncommon Urogenital Congenital Anomaly, Zinner Syndrome—A Case Report

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1735503 ◽

2021 ◽

Author(s):

Rajani Gorantla ◽

Sameera Allu ◽

Ankamma Rao

Keyword(s):

Congenital Anomaly ◽

Renal Agenesis ◽

Early Adulthood ◽

Ejaculatory Duct ◽

First Trimester ◽

Reproductive Activity ◽

Urogenital System ◽

Unilateral Renal Agenesis ◽

Duct Obstruction ◽

Ejaculatory Duct Obstruction

AbstractZinner syndrome is a rare congenital anomaly of the urogenital system resulting from an in utero insult during the first trimester. This entity comprises a triad of unilateral renal agenesis/dysgenesis with ipsilateral seminal vesical and ejaculatory duct obstruction. This combination of urinary and genital abnormalities occurs because of the closely related embryological origin of these structures from the distal mesonephric (Wolffian) duct. Nearly 200 cases of seminal vesical cysts with ipsilateral renal agenesis have been reported in the literature. The affected person generally presents in early adulthood when the reproductive activity commences. In this report, we present a case of a 22-year-old male with complaints of painful ejaculation.

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Rare Cause of Painful Ejaculation – Zinner’s Syndrome: A Case Report

American Journal of Sonography ◽

10.25259/ajs_2_2020 ◽

2020 ◽

Vol 3 ◽

pp. 1

Author(s):

Devimeenal Jaganathan ◽

Gopinathan Kathirvelu ◽

Suriyaprakash Nagarajan ◽

Usha Nandhini Ganesan

Keyword(s):

Seminal Vesicle ◽

Renal Agenesis ◽

Ejaculatory Duct ◽

Resonance Imaging ◽

Unilateral Renal Agenesis ◽

Common Complaint ◽

Radiologic Imaging ◽

Rare Congenital Abnormality ◽

Ejaculatory Duct Obstruction ◽

Zinner’S Syndrome

Zinner’s syndrome is a rare congenital abnormality consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. The mutual embryological origins of the seminal vesicle and the ureteral bud from the Wolffian duct result in both anomalous seminal vesicle and urinary tracts. Most cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. The usual presentation is between the third and fourth decades of life, with infertility being the most common complaint. Ultrasound and magnetic resonance imaging can easily detect this condition. We present here an extremely rare developmental anomaly involving the Wolffian ducts, which would remain undiagnosed but for radiologic imaging.

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A wide spectrum of rare clinical variants of Zinner syndrome

BMJ Case Reports ◽

10.1136/bcr-2020-239254 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239254

Author(s):

Harkirat Singh Talwar ◽

Ankur Mittal ◽

Tushar Aditya Narain ◽

Vikas Kumar Panwar

Keyword(s):

Congenital Malformations ◽

Renal Agenesis ◽

Wide Spectrum ◽

Ejaculatory Duct ◽

Seminal Vesicles ◽

Duct Obstruction ◽

Cyst Excision ◽

Maintenance Haemodialysis ◽

Clinical Variants ◽

Ejaculatory Duct Obstruction

Congenital malformations of the seminal vesicles (SVs) are rare and are associated with abnormalities of the ipsilateral urinary tracts as embryologically both the ureteral buds and SVs arise from the mesonephric ducts. The triad of SV cysts, ipsilateral renal agenesis and ejaculatory duct obstruction is known as the Zinner syndrome. We, herein, present three very rare presentations of Zinner syndrome. Case 1 presented with haematuria, and was found to have a large SV cyst with stones and underwent a robotic cyst excision. Case 2 presented with primary infertility, and was found to have a variant of Zinner syndrome. Case 3 was a known case of chronic kidney disease on maintenance haemodialysis who presented with fever and oliguria. He was found to have Zinner syndrome and underwent aspiration of SV abscess. To the best of our knowledge, such varying presentations of Zinner syndrome have been rarely reported thus far.

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Zinner Syndrome with Ectopic Ureter Remnant

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210608151618 ◽

2021 ◽

Vol 17 ◽

Author(s):

Ara Ko ◽

Sung Bin Park ◽

Hyun Jeong Park ◽

Eun Sun Lee

Keyword(s):

Seminal Vesicle ◽

Ejaculatory Duct ◽

Outlet Obstruction ◽

Ectopic Ureter ◽

Cystic Dilatation ◽

Unilateral Renal Agenesis ◽

Rare Congenital Abnormality ◽

Mesonephric Duct ◽

Clinical Triad ◽

Ejaculatory Duct Obstruction

: Zinner syndrome is a rare congenital abnormality defined by a clinical triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. Most patients are asymptomatic, but if the cystic dilatation of the seminal vesicle becomes significant, it can result in urinary symptoms such as dysuria and urinary retention. This rare developmental anomaly related to the mesonephric duct can also present with other abnormalities. Here, we report our experience of Zinner syndrome with bladder outlet obstruction and an ectopic ureter remnant.

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Long-Term Surveillance and Laparoscopic Management of Zinner Syndrome

Case Reports in Urology ◽

10.1155/2021/6626511 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Niall P. Kelly ◽

Adrian Fuentes-Bonachera ◽

William P. Shields ◽

Ivor M. Cullen ◽

Padraig J. Daly

Keyword(s):

Renal Transplant ◽

Seminal Vesicle ◽

Ejaculatory Duct ◽

Treatment Strategies ◽

Surgical Excision ◽

Initial Diagnosis ◽

Unilateral Renal Agenesis ◽

Laparoscopic Management ◽

Seminal Vesicle Cyst ◽

Laparoscopic Excision

Zinner syndrome was first described in 1914 and represents the triad of unilateral renal agenesis and ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. Seminal vesicle cysts are often asymptomatic but can also present with pain, haematospermia, or other lower urinary tract symptoms. Treatment strategies include observation and surgical excision. We present the laparoscopic management of an enlarged seminal vesicle cyst, consistent with Zinner syndrome, 14 years after the initial diagnosis. A 58-year-old male patient was diagnosed with a left-sided seminal vesicle cyst while undergoing assessment for renal transplant due to progressively worsening renal function in his solitary right kidney. The otherwise asymptomatic cyst enlarged from the time of initial diagnosis in 2004 ( 11.3 cm × 9.7 cm × 13.1 cm ) to nearly double the size in 2018 ( 12.8 cm × 11.9 cm × 14.2 cm ). This cyst size ultimately precluded renal transplant, and the patient was referred for excision. Laparoscopic excision of the cyst was performed, histopathology confirmed seminal vesicle cyst tissue, and there has been no recurrence of the cyst to date. The patient remains active on the renal transplant waitlist. Zinner syndrome is a rare syndrome, with the seminal vesicle cysts being managed by observation or surgical excision. We report the longest documented observation of a seminal vesicle cyst, culminating in a safe and successful laparoscopic excision.

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1624: Technetium-99m Sulfur Colloid Seminal Vesicle Scintigraphy: A Novel Approach for the Diagnosis of Ejaculatory Duct Obstruction

The Journal of Urology ◽

10.1016/s0022-5347(18)33816-3 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 523-523

Author(s):

Irfan Orhan ◽

Imed Duksal ◽

Rahmi Onur ◽

Tansal A. Balci ◽

Kursad Poyraz ◽

...

Keyword(s):

Seminal Vesicle ◽

Ejaculatory Duct ◽

Sulfur Colloid ◽

Duct Obstruction ◽

Technetium 99M ◽

Novel Approach ◽

Ejaculatory Duct Obstruction

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Renal agenesis with ureterocele, duplicated megaureter and translocation of seminal vesicle: a case report and review of the literature

10.31083/jomh.2021.088 ◽

2021 ◽

pp. 1

Keyword(s):

Emergency Department ◽

Case Report ◽

Seminal Vesicle ◽

Rare Case ◽

Renal Agenesis ◽

Pathological Examination ◽

Unilateral Renal Agenesis ◽

Abnormal Finding ◽

Treatment Data ◽

Proximal Ureter

Background: Renal agenesis is a congenital malformation that occurs due to the inhibition of metanephric blastema induction due to a decrease in ureteric bud activity. Although renal agenesis is not very rare, unilateral renal agenesis with ureterocele occurs rarely, and the coexistance of unilateral renal agenesis, ureterocele, and blind ended proximal ureter is very rare. Recently, we experienced a case of left renal agenesis with huge ureterocele, blind ended proximal ureter, and duplicated ureter on Computed tomography (CT) of a 17-year-old man who visited our emergency department with hematuria. Ureterocelectomy and nephrectomy were performed, and a translocation of seminal vesicle was also observed. This case is a very rare case, so we judged that it may be helpful in making treatment decisions in similar cases later. Case summary: A 17-year-old man without specific medical history visited our emergency department with hematuria and voiding difficulty. CT showed left ectopic kidney, megaureter and the blind ended proximal ureter. After ureterocelectomy and nephrectomy, pathological examination revealed seminal vesicles in the periphery of the kidney. After one year, the patient has no complications and no complaining symptoms complaints without any abnormal finding of follow up imaging test. Conclusions: This case report focuses on the treatment of renal agenesis with ureterocele, blind ended proximal ureter, duplicated megaureter and translocation of seminal vesicle. This rare case of treatment will be helpful in the determination of treatment for similar cases in the future. To establish standard treatment, data accumulation and well-designed studies are required.

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