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Pakkasjärvi N, Mönttinen T, Hokkinen L, Mäkelä E, Taskinen S. Retrovesical cysts in boys—case series and literature review. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00228-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Retrovesical cysts present with varying etiologies. We initiated this study to provide insights into retrovesical cysts in boys through a case series and systematic literature review and to aid in treatment alternatives.
Materials and methods
Case series of seven patients from the in-hospital register with a systematic literature review on retrovesical cysts in children.
Results
We identified seven patients from the in-hospital register during 2005–2020 and eighty-two patients from the literature review. The literature review showed that children’s retrovesical cysts are mainly asymptomatic before puberty. Those detected earlier in childhood present mostly with renal abnormalities. In our series, retrovesical cysts derived from three distinct etiologies with different treatment modalities. Asymptomatic cysts do not need excision and are to be followed up through puberty, but in the case of an ectopic ureter, nephroureterectomy is optional. Symptomatic retrovesical cysts may demand surgical excision. Ultrasonography is usually sufficient for diagnosis, but MRI provides better anatomical delineation and aids in surgical planning.
Conclusions
Retrovesical cysts in boys are benign conditions associated with abnormal development of the ureter and kidney. Ultrasonography is sufficient for diagnosis, with MRI giving further detail for surgical planning. Treatment consists of cyst excision, heminephrectomy/nephrectomy, transurethral canalization, or excision of prostatic utricle, depending on etiology. Asymptomatic cases are to be followed up through puberty, but in cases of an ectopic ureter, nephroureterectomy is preferred.
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Lin CC, Sheu JC, Tsai PS, Lee MD, Lin TH, Tsai JD. Zinner syndrome in children: clinical presentation, imaging findings, diagnosis, and outcome. Pediatr Nephrol 2022; 37:3075-3084. [PMID: 35332378 DOI: 10.1007/s00467-022-05516-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Chun-Chen Lin
- Department of Pediatrics, MacKay Children's Hospital, No 92, Section 2, Chungshan North Road, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Jin-Cherng Sheu
- Department of Pediatric Surgery, MacKay Children's Hospital, Taipei, Taiwan
| | - Pei-Shan Tsai
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Dar Lee
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Tsu-Hua Lin
- Department of Pediatrics, MacKay Children's Hospital, No 92, Section 2, Chungshan North Road, Taipei, Taiwan
| | - Jeng-Daw Tsai
- Department of Pediatrics, MacKay Children's Hospital, No 92, Section 2, Chungshan North Road, Taipei, Taiwan. .,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan. .,Department of Medicine, Taipei Medical University, Taipei, Taiwan.
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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.
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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
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