Laparoendoscopic single-site surgery (LESS) for excision of a seminal vesicle cyst associated with ipsilateral renal agenesis

Zinner's syndrome, a retrospective series of three cases: different strategies to the same problem

A 106 years have passed since Zinner's syndrome was first described and current knowledge is still almost exclusively based on case reports. This article presents three patients with Zinner's syndrome with different clinical presentations and consequent different treatment options, showing the possible full spectrum of this condition. The first patient presented with storage lower urinary tract symptoms and benefited from laparoscopic removal of the seminal vesicle. The second patient has an incidental diagnosis on CT and remains asymptomatic on follow-up. The third patient presented with persistent lumbar pain and underwent open surgical removal of the seminal vesicle. The authors further present a literature review of the current knowledge on this topic, hopefully to clarify the state of art and improve the management of these patients.

The first magnetic resonance imaging-detected case of bilateral seminal vesicle duplication: An illustrative case report

Given the increasing use of prostate magnetic resonance imaging (MRI) for imaging suspected cancer and male infertility, understanding imaging features of congenital anomalies of the seminal vesicles (SVs) is of clinical importance. This case presents the first MRI-detected case of bilateral SV duplication with an isolated right SV cyst in the absence of other congenital genitourinary anomalies. In addition to illustrating imaging features of this rare anomaly, this case provides an overview of the role of MRI in providing accurate diagnosis and guiding management options of the most common SV anomalies.

Guiding role of seminal tract anatomical study in transurethral seminal vesiculoscopy

Introduction

There have been problems with low qualification operator-related complications and failures of transurethral seminal vesiculoscopy (TSV) in China.

Aim

To study the guiding role of seminal tract anatomical study (STAS) in TSV.

Material and methods

We performed STAS to study the structure, morphology, duct trajectory, and anatomical relationships between the seminal vesicles and the adjacent tissue in pelvic specimens from 12 adult cadavers. Then the surgical effects and complications of 82 cases of TSV performed by 3 doctors were retrospectively studied to compare the difference between the two groups of before and after the anatomical study.

Results

The anatomical studies of the 12 adult cadaveric pelvis specimens identified the lengths and widths of the right- and left-side seminal vesicles and tracts. The TSV can treat lesions located in the distal seminal tract and vesicle, but proximal lesions cannot be reached, which is an anatomical limitation of this technique. There were significant differences in the surgical times and the surgical validity rates between the 2 groups.

Conclusions

Our anatomical study of the seminal tract and seminal vesicles is valuable for guiding TSV in clinical practice.

Leiomyoma arising from the right seminal duct/seminal vesicle-Report of a rare case and review of the literature

We present a case of a patient with a large, symptomatic abdominal tumour, which finally could be classified as a leiomyoma arising from the right seminal duct/seminal vesicle. In computed tomography (CT) scan, it appeared as a 7.5 × 6.5 cm solid, supravesical mass. A cystoscopy as well as bilateral retrograde studies was normal, a transrectal ultrasound-guided biopsy and an ultrasound-guided transabdominal biopsy of the mass were inconclusive. Subsequently, we performed a tumour extirpation through a lower midline laparotomy. Histological examination showed a leiomyoma arising from the right seminal duct or seminal vesicle. In this article, we discuss clinical presentation, findings on imaging and management of this rare benign tumour and review the relevant literature where only 13 similar cases could be identified.

Laparoscopic Surgery for Seminal Vesicle Cysts and Ureterocele with Urination Disorder: A Case Report of Zinner Syndrome

Background: Zinner syndrome is defined as seminal vesicle cysts with ipsilateral renal agenesis and an ectopic ureter. Symptomatic cases are very rare. In this article, we present a laparoscopic approach for a case of Zinner syndrome.

Case Presentation: The patient was a 21-year-old male with difficult urination. A right seminal vesicle cyst and right kidney agenesis associated with ureterocele were found on examination and he was diagnosed with Zinner syndrome. First, we performed transperineal puncture of the ureterocele because it closed the bladder neck during voiding. Although voiding symptoms temporarily improved, the ureterocele recurred soon and the urination disorder was reexacerbated. Next, we selected laparoscopic removal of the ureterocele and the seminal vesicle cyst. The procedure was performed with transperitoneal access using four trocars. Perioperative and postoperative complications were not observed, and micturition was satisfactory after surgery.

Conclusion: Treatment for difficult urination because of Zinner syndrome is mostly selected puncture of the ureterocele or seminal vesicle cyst. However, some patients experience recurrence. The laparoscopic approach is minimally invasive and provides a satisfactory surgical field. Therefore, it should be considered the method of treatment for symptomatic Zinner syndrome.

Laparoscopic removal of a congenital seminal vesicle cyst in Zinner's syndrome

Introduction:

Seminal vesicle cysts are rarely diagnosed, but symptomatic congenital seminal vesicle cysts are reported in the literature describing Zinner syndrome.

Case Description:

We present the case of a 26-year-old patient admitted to the urology department because of abdominal pain. A left seminal vesicle cyst and left kidney agenesis were found on examination, and the patient qualified for laparoscopic removal of the left seminal vesicle cyst. The procedure was performed with transperitoneal access using 5 trocars. The peritoneum was incised between the bladder and the rectum to reveal the left seminal vesicle, which was resected from the surrounding tissue. A TachoSil (Takeda Pharmaceuticals, Zurich, Switzerland) hemostatic sponge was placed in the ledge after cutting the base of the seminal vesicle.

Discussion:

The aim of this study was to evaluate usefulness of the laparoscopic technique to remove a cystic seminal vesicle. The procedure lasted 180 minutes, and the estimated blood loss was 50 mL. We did not record any intra- or postoperative complications. The patient was discharged from the hospital on the third postoperative day and remains symptom-free after 12 months. Histopathologic examination confirmed the presence of a seminal vesicle cyst, and renal agenesis and stenosis of the vas deferens suggests Zinner syndrome. Symptomatic seminal vesicle cysts are a good indication for the application of a laparoscopic technique and, in our opinion, this is better than the open technique because of the view into the surgical area. Therefore, it should be used as the method of choice in treating seminal vesicle defects.

Transperitoneal laparoscopic excision of seminal vesicle cyst: a single-center experience

BACKGROUND AND PURPOSE

Seminal vesicle cyst (SVC) is a rare disease and its treatment is still controversial. This article contains the largest series of transperitoneal laparoscopic excision of SVC to date, summarizing our surgical techniques and clinical experience with this disease.

PATIENTS AND METHODS

From December 2003 to May 2010, seven patients received transperitoneal laparoscopic excision of SVC using a five-port transperitoneal approach. Nearly the total cyst was removed by only leaving a narrow strip of the cyst wall with the bilateral vas deferens and SV preserved completely. Pelvic CT or MRI was performed 3 and 6 months after surgery, and thereafter annually for at least 3 years.

RESULTS

Transperitoneal laparoscopic excision of SVC was completed successfully in all seven patients without conversion to open surgery. The mean operative time was 73 minutes (range 60-100 min) with negligible blood loss (less than 20 mL). The mean postoperative hospital stay was 4.3 days (range 3-5 days). No intraoperative or postoperative complication occurred. The patients were followed up for a mean of 45 months (range 18-84 mos), during which they all remained symptom free with normal erectile and ejaculatory function without evidence of recurrence.

CONCLUSION

Our study has demonstrated that transperitoneal laparoscopic excision of SVC is a safe, feasible, and efficacious procedure, and offers an excellent option for minimally invasive treatment of patients with SVC.