Classifying seminal vesicle cysts in the diagnosis and treatment of Zinner syndrome: A report of six cases and review of available literature

Abstract

This study aims to emphasise the importance of imaging in the diagnosis and treatment decision‐making in Zinner syndrome and provide a classification for seminal vesicle cysts. The data of six patients with Zinner syndrome in a single institution were collected. All patients underwent a contrast‐enhanced computed tomography (CT) exam. Among these patients, five patients also underwent an magnetic resonance imaging (MRI). These results were combined with the review of available literature to classify the seminal vesicle cysts. Among these patients, two patients had urinary urgency and frequency, while four patients had no urinary symptoms. No reproductive‐system symptoms were revealed. The imaging revealed left‐sided involvement in two patients and right‐sided involvement in four patients. The associated features included ipsilateral renal agenesis, seminal vesicle cyst or agenesis, and ejaculatory duct obstruction. Either an ipsilateral ureterocele or an ipsilateral small testis was noted. The seminal vesicle cysts demonstrated varying attenuation or intensity in the imaging. Imaging (CT and especially MRI) can be critical in the noninvasive diagnosis of Zinner syndrome and in allowing aberrant anatomy to be displayed for possible surgery. The proposed seminal vesicle cyst imaging classification could potentially contribute to clinical decision‐making.

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

“… [2] Small sized testis and ureterocele of the same side have also been reported. [7] On digital rectal examination there may be presence of well-defined cystic lesion palpable adjacent to the seminal vesicle however it can remain undetected on physical examination. [8] …”

Zinner Syndrome Unmasked by Workup for Renal Colic and Uncontrolled Hypertension

“…Recently, robotic-assisted interventions have shown to have curative potential in patients with long-standing local symptoms [10]. For patients with only symptoms related to seminal vesicle cysts, literature favors the transurethral unroofing as the treatment option [11]. Van den Ouden et al, while reporting data for 52 patients, demonstrated a 100% success rate of surgical excision of seminal vesicle cysts compared to a 75% success rate with transurethral unroofing [12].…”

Zinner syndrome: an up-to-date literature review based on an asymptomatic clinical case

“…La asociación de esta entidad nace del origen embriológico común del riñón y la vesícula seminal, a partir del conducto mesonéfrico o de Wolff, y es secundaria a una alteración en la embriogénesis entre las semanas 4 y 13 de gestación. (5,6) Normalmente, la yema ureteral asciende desde la parte dorsal del conducto mesonéfrico distal y se extiende dorsocranealmente para encontrarse con el blastema metanéfrico e inducir su diferenciación, formándose así el riñón. El conducto mesonéfrico se diferenciará en el epidídimo, conducto deferente, vesícula seminal, conducto eyaculador y hemitrígono.…”