Challenging clinical presentation of Zinner syndrome

Sada, F.; Cekaj, Elton; Saraci, Blerina; Al-Madani, Abdallah; Jahanian, Sepideh; Nahar, Shamsun; Musa, Juna; Mamillo, Keti; Musliu, Dijon; Ahadi, Murtaza; Leniqi, Florim; Agarwal, Tamanna; Hyseni, Fjolla; Vokshi, Valon; Fink, Adam; Deepali, FNU; Shatri, Jeton; Bexheti, Sadi

doi:10.1016/j.radcr.2022.10.006

Cited by 4 publications

(10 citation statements)

References 9 publications

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“…Regarding infertility with Zinner syndrome, prior studies revealed 15% of patients initially presented with complaints of primary infertility, with 45% found to be infertile at the time of their diagnosis. 5,7,13,16,17 The cause of infertility is usually related to the enlarged ipsilateral ejaculatory duct blocking the contralateral ejaculatory duct. 6,16-23 However, oligospermia and azoospermia have been reported in patients with Zinner syndrome with a patent contralateral ejaculatory duct.…”

Section: Discussionmentioning

confidence: 99%

“…found to be infertile at the time of their diagnosis. 5,7,13,16,17 The cause of infertility is usually related to the enlarged ipsilateral ejaculatory duct blocking the contralateral ejaculatory duct. 6,[16][17][18][19][20][21][22][23] However, oligospermia and azoospermia have been reported in patients with Zinner syndrome with a patent contralateral ejaculatory duct.…”

Section: Fertility Concernsmentioning

confidence: 99%

“…5,7,13,16,17 The cause of infertility is usually related to the enlarged ipsilateral ejaculatory duct blocking the contralateral ejaculatory duct. 6,[16][17][18][19][20][21][22][23] However, oligospermia and azoospermia have been reported in patients with Zinner syndrome with a patent contralateral ejaculatory duct. 6,7,[17][18][19][20][21][22] This finding resulted in the hypothesis that infertility secondary to Zinner syndrome may be due to a spectrum of etiologies, including the presence of contralateral wolffian duct or gonadal abnormalities, anti-sperm antibodies, or contralateral geminal epithelial damage arising from inflammation due to an infected SVC.…”

Section: Fertility Concernsmentioning

confidence: 99%

“…Classically two-thirds of the patients with Zinner syndrome will present with LUTS. [4][5][6][7]16 Presumably, the onset of LUTS is secondary to the dilated SVC compressing the bladder outlet. 4,6,7 In patients with LUTS, we have found it to be beneficial to perform a screening uroflow with an ultrasound residual urine, followed by UDS if the uroflow is abnormal.…”

Section: Luts and Zinner Syndromementioning

confidence: 99%

“…Persistent screening >20 years of age was of little benefit, with a yield of 0.33% (1/296). Twenty percent (4/20) of patients had both their congenital solitary kidney and the Zinner syndrome incidentally diagnosed on radiographic studies at the ages of 15 (1 patient), 16 (2 patients), and 18 (1 patient) years.…”

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confidence: 99%

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Screening for Zinner Syndrome in Patients With a Congenitally Solitary Kidney: Lessons Learned

Bearrick,

Husmann

2023

Journal of Urology

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Purpose:We determined if serial screening ultrasounds are beneficial in evaluating for the development of Zinner syndrome in males with a congenital solitary kidney.Materials and Methods:All patients included had their congenital solitary kidney diagnosed at <20 years of age and had to be ≥20 at their last visit. Individuals were seen annually, with pelvic ultrasounds to screen for mesonephric duct cysts obtained at birth and every year of age, divisible by 5.Results:At a median follow-up of 38 years of age (range 20-57), 17% (20/121) developed Zinner syndrome, with 60% (12/20) developing clinical symptoms. The yield for screening ultrasound studies was significantly higher in patients ≤20 years of age at 3.5% (12/340), compared to 0.33% (1/296) in patients >20 years of age (P = .004). Serial ultrasounds reveal the onset of lower urinary tract and cyst-related pain symptoms are associated with the growth of the seminal vesicle cyst to ≥5 cm (P = .0198). Of symptomatic patients, 75% (8/12) had abnormal uroflows. Complete urodynamic studies revealed findings consistent with bladder outlet obstruction in 38% (3/8), equivocal for obstruction in 24% (2/8), and detrusor underactivity in 38% (3/8). Cyst excision effectively resolved voiding symptoms that were obstructive in etiology but failed to resolve symptoms in patients with detrusor underactivity.Conclusions:Serial ultrasound evaluations reveal that cyst growth to ≥5 cm in size is highly related to the onset of clinical symptoms, with the resolution of voiding symptoms by cyst excision directly associated with urodynamic findings.

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Section: Discussionmentioning

confidence: 99%

Section: Fertility Concernsmentioning

confidence: 99%

Section: Fertility Concernsmentioning

confidence: 99%

Section: Luts and Zinner Syndromementioning

confidence: 99%

mentioning

confidence: 99%

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Screening for Zinner Syndrome in Patients With a Congenitally Solitary Kidney: Lessons Learned

Bearrick,

Husmann

2023

Journal of Urology

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The role of radiology in diagnosis of Zinner syndrome in a young man with scrotal pain

Zare,

Narouie,

Moloudi

et al. 2023

Radiology Case Reports

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A Rare Variant of Zinner Syndrome Involving Ectopic Ureteral Implantation into the Seminal Vesicle Causing Recurrent Epididymitis

Zaliznyak,

Baer,

Trierweiler

et al. 2024

Case Reports in Urology

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Zinner syndrome is a rare congenital anomaly characterized by a triad of renal dysgenesis/agenesis, cysts in the ipsilateral seminal vesicle, and ejaculatory duct obstruction. Though often diagnosed in infancy, the diagnoses can be incidentally found in adults who present with nonspecific genitourinary symptoms including dysuria, ejaculatory dysfunction, or genital pain. We present an unusual case of a 29-year-old male patient who presented to the emergency department with recurrent testicular pain and hematospermia and was found to have an atrophic right kidney with an ectopic ureter implanting into a cystic seminal vesicle. These findings were consistent with a rare subvariant of Zinner syndrome only previously described four times in the literature. We performed a robotic-assisted laparoscopic ectopic nephroureterectomy with sparing of his seminal vesicle. To our knowledge, this is the first report to describe the safe and effective use of robotic surgery in this setting to remove affected anatomy while preserving the patient’s seminal vesicle.

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Challenging clinical presentation of Zinner syndrome

Cited by 4 publications

References 9 publications

Screening for Zinner Syndrome in Patients With a Congenitally Solitary Kidney: Lessons Learned

Screening for Zinner Syndrome in Patients With a Congenitally Solitary Kidney: Lessons Learned

The role of radiology in diagnosis of Zinner syndrome in a young man with scrotal pain

A Rare Variant of Zinner Syndrome Involving Ectopic Ureteral Implantation into the Seminal Vesicle Causing Recurrent Epididymitis

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