1
|
Al-Smair A, Mahmoud MM, Attal MT, Alzawawi IN. A variant of Zinner syndrome with ectopic ureteral insertion into the seminal vesicle. Radiol Case Rep 2024; 19:2663-2668. [PMID: 38645947 PMCID: PMC11033097 DOI: 10.1016/j.radcr.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
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.
Collapse
Affiliation(s)
| | | | - Murad T. Attal
- The University of Jordan, Faculty of Medicine, Amman, Jordan
| | | |
Collapse
|
2
|
Zhong H, Han LZ, Yue CJ, Liu ZZ. A symptomatic case of Zinner syndrome: Laparoscopic seminal vesiculectomy and ipsilateral nephroureterectomy. Asian J Surg 2023; 46:4527-4529. [PMID: 37225570 DOI: 10.1016/j.asjsur.2023.04.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- Hao Zhong
- Department of Urology, Inner Mongolia Baogang Hospital, Third Affiliated Hospital of Inner Mongonia Medical University, Baotou, 014010, China
| | - Li-Zhong Han
- Department of Urology, Inner Mongolia Baogang Hospital, Third Affiliated Hospital of Inner Mongonia Medical University, Baotou, 014010, China
| | - Chang-Jiu Yue
- Department of Urology, Inner Mongolia Baogang Hospital, Third Affiliated Hospital of Inner Mongonia Medical University, Baotou, 014010, China
| | - Zhi-Zhong Liu
- Department of Urology, Inner Mongolia Baogang Hospital, Third Affiliated Hospital of Inner Mongonia Medical University, Baotou, 014010, China.
| |
Collapse
|
3
|
Kumar S, G KI, Khalil-Khan A, Arul Pitchai ADP, Sathiamoorthy R, Raju E. Zinner Syndrome. Cureus 2022; 14:e31308. [DOI: 10.7759/cureus.31308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
|
4
|
Grund C, Krieg VM, Leißner J. [And there was Zinner's syndrome-a rare differential diagnosis]. Urologe A 2022; 61:1243-1248. [PMID: 35420318 DOI: 10.1007/s00120-022-01828-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
Zinner's syndrome is a rare congenital abnormality of the Wolffian ducts in male patients. It consists of the triad of renal agenesis, ipsilateral seminal vesicle dilatation, and obstruction of the ejaculatory duct. Symptoms often occur after puberty and can include hematospermia, painful ejaculation, dysuria, and local discomfort. We present the case of a 15-year-old patient with this rare condition who was treated surgically after the diagnosis was confirmed.
Collapse
Affiliation(s)
- Christina Grund
- Urologgia, Urologie im Helios Haus, Venloer Str. 389, 50825, Köln, Deutschland.
| | - Victoria Margaux Krieg
- Urologische Klinik, Kliniken der Stadt Köln gGmbH, Neufelder Str. 32, 51067, Köln, Deutschland
| | - Joachim Leißner
- Urologische Klinik, Kliniken der Stadt Köln gGmbH, Neufelder Str. 32, 51067, Köln, Deutschland
| |
Collapse
|
5
|
Militaru V, Mihaly ZA, Ilea C, Coman M, Stanciu M, Crisan N, Coman I. Zinner syndrome - case report. Med Pharm Rep 2021; 94:S47-S50. [PMID: 34527910 DOI: 10.15386/mpr-2229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We present the case of a 51-year-old male with Zinner syndrome, which is a rare disease, resulting from an abnormal evolution of the mesonephric (Wolffian) duct. It consists in cystic dilations of one seminal vesicle and/or ejaculatory duct and ipsilateral renal agenesis. It leads to symptoms related to urination, ejaculation, even infertility, and to low-abdomen and perineal pain. The diagnosis is set by ultrasonography, CT scan and, mainly, MRI. Usually it is treated conservatively, but certain cases require surgery, nowadays minimally invasive.
Collapse
Affiliation(s)
- Valentin Militaru
- 5 Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Internal Medicine Department, Cluj-Napoca Municipal Hospital, Romania
| | | | - Catalin Ilea
- Emergency Medicine Department, Cluj-Napoca Municipal Hospital, Romania
| | - Mihaela Coman
- Radiology Department, Cluj-Napoca Municipal Hospital, Romania
| | - Mihaela Stanciu
- Radiology Department, Cluj-Napoca Municipal Hospital, Romania
| | - Nicolae Crisan
- Urology Department, Cluj-Napoca Municipal Hospital, Romania.,2 Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Coman
- 2 Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
6
|
Zinner Syndrome with Ectopic Ureter Emptying into Seminal Vesicle. Case Rep Urol 2021; 2021:8834127. [PMID: 33575058 PMCID: PMC7857894 DOI: 10.1155/2021/8834127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 11/18/2022] Open
Abstract
A 66-year-old male patient in follow-up in the urology department for a non-muscle-invasive bladder cancer was detected by ultrasound to have absence of the left kidney and a cystic, multilobed image at the location of the seminal vesicle. Magnetic resonance imaging reveals left renal agenesis and the existence of multiple cysts in the ipsilateral seminal vesicle that reaches a size of 6.9 × 3.7 cm, as well as a ureteral remnant that opens into the seminal vesicle. The patient does not present urinary symptoms, neither pain with ejaculation nor hematuria. A triad of seminal vesicle cyst, ipsilateral renal agenesis, and ipsilateral ejaculatory duct obstruction is known as Zinner syndrome. Congenital anomalies of the seminal vesicles are rare; some of them are associated with malformations of the upper urinary system. Seminal vesicle cysts are associated with ipsilateral renal agenesis and ectopic or dysplastic ureter. Patients may remain asymptomatic and be diagnosed incidentally or may present with symptoms such as increased urinary frequency, dysuria, recurrent infections, pain with ejaculation, and perineal discomfort.
Collapse
|
7
|
Cito G, Gemma L, Giachini C, Micelli E, Cocci A, Fucci R, Picone R, Sforza S, Nesi G, Santi R, Minervini A, Masieri L, Carini M, Coccia ME, Natali A. Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome. Clin Exp Reprod Med 2021; 48:85-90. [PMID: 33486943 PMCID: PMC7943355 DOI: 10.5653/cerm.2020.03769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022] Open
Abstract
We present data from three Caucasian men with Zinner syndrome who attended our center for the treatment of primary couple’s infertility. Each patient was scheduled for conventional testicular sperm extraction (cTESE) and cryopreservation. Sperm analysis confirmed absolute azoospermia. Patient 1 had right and left testis volumes of 24 mL and 23 mL, respectively; left seminal vesicle (SV) agenesis, severe right SV hypotrophy with right renal agenesis. Follicle-stimulating hormone (FSH) was 3.2 IU/L. Patient 2 exhibited right and left testis volumes of 18 mL and 16 mL, respectively; a left SV cyst of 32 × 28 mm, ipsilateral kidney absence, and right SV agenesis. FSH was 2.8 IU/L. Patient 3 showed a testicular volume of 10 mL bilaterally, a 65 × 46 mm left SV cyst, right SV enlargement, and left kidney agenesis. FSH was 32.0 IU/L. Sperm retrieval was successful in all patients. Nevertheless, cTESE should be performed on the day of oocyte retrieval.
Collapse
Affiliation(s)
| | - Luca Gemma
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Simone Sforza
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Gabriella Nesi
- Pathology Section, Department of Health Sciences, University of Florence, Florence, Italy
| | - Raffaella Santi
- Pathology Section, Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Marco Carini
- Department of Urology, Careggi Hospital, Florence, Italy
| | | | | |
Collapse
|