Partial vesiculectomy in an infertile man with seminal vesicle cyst, ipsilateral renal agenesis, and cryptorchidism

Seminal Vesicle Cyst and Ipsilateral Renal Agenesis: Laparoscopic Approach

“…Most seminal vesicle cysts are congenital, and two-thirds are associated with renal agenesis or dysplasia [Cherullo et al 2002;Ikari et al 1999;Patel et al 2002]. Since Zinner [1914] initially reported the association of a congenital seminal vesicle cyst with ipsilateral renal agenesis, there have been about 50 published cases [Carmignani et al 1995;Gozen and Alagol 2006;Liatsikos et al 2004;Manousakas et al 2002;Patel et al 2002]. The formation of congenital seminal vesicle cyst with ipsilateral renal agenesis is believed to result from abnormal embryonic development of the distal portion of the mesonephric duct [Hoschke et al 2003;Patel et al 2002;Zinner 1914].…”

“…When symptoms occur, patients may present with complaints such as irritative or obstructive voiding, hemospermia, perineal pain, infertility, or post-coital discomfort [Basillote et al 2004;Carmignani et al 1995;Cherullo et al 2002;Gozen and Alagol 2006;Haringanji et al 2004;Hoschke et al 2003;Ikari et al 1999;Ishida et al 2006;Liatsikos et al 2004;Manousakas et al 2002;McDougall et al 2001;Moudouni et al 2006;Okoye et al 1995;Ozgok et al 2005;Patel et al 2002;Razvi and Denstedt 1994;Valla et al 2003]. Diagnostic procedures include abdominopelvic and transrectal ultrasonography, CT, MRI, intravenous urography or seminovesiculography.…”

“…However, conservative management usually has not been effective, and surgical management may be necessary for alleviation of symptoms. Surgical treatment of symptomatic cysts has included transrectal ultrasonography guided fine needle cyst aspiration, transurethral unroofing, transurethral resection of the ejaculatory duct, transurethral endoscopic aspiration or open surgical excision [Manousakas et al 2002;Okoye et al 1995;Patel et al 2002;Razvi and Denstedt 1994]. However, the seminal vesicles are difficult to access surgically because of their deep location within the pelvis, and all transrectal, transurethral or open surgical approaches have inherent shortcomings.…”

“…However, the seminal vesicles are difficult to access surgically because of their deep location within the pelvis, and all transrectal, transurethral or open surgical approaches have inherent shortcomings. Open operation has been traditionally considered the definitive form of treatment, but requires extensive dissection and may be associated with a high rate of morbidity (Manousakas et al 2002;Patel et al 2002). A transrectal or transurethral surgical approach provides only transient relief of symptoms and may cause certain morbidities including infection, urinary reflux and retrograde ejaculation [Okoye et al 1995;Razvi and Denstedt 1994].…”

“…When the patient is symptomatic, surgical treatment may be necessary. However, the seminal vesicle is difficult to access surgically, and all transrectal, transurethral or open surgical approaches have inherent shortcomings [Gozen and Alagol 2006;Ishida et al 2006;Manousakas et al 2002;Okoye et al 1995;Ozgok et al 2005;Razvi and Denstedt 1994]. Recently, laparoscopy has become an alternative approach to seminal vesicle pathology that offers excellent intraoperative access and minimal postoperative morbidity [Basillote et al 2004;Carmignani et al 1995;Cherullo et al 2002;Haringanji et al 2004;Hoschke et al 2003;Ikari et al 1999;Liatsikos et al 2004;Moudouni et al 2006;Valla et al 2003].…”