Robotic management of painful Zinner syndrome, case report and review of literature

Demaeyer, Laura; Holz, Serge; Pamart, Didier; Taylor, Steven; Naudin, Michel

doi:10.1016/j.ijscr.2020.06.078

Cited by 7 publications

(11 citation statements)

References 12 publications

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“…Likewise, Demaeyer et al decided to use a robotic-assisted approach to completely remove the cyst and the right seminal vesicle of a 33-year-old man with symptomatic Zinner’s syndrome. They suggested that minimally invasive approaches, similar to conventional and robotic-assisted laparoscopy, should be considered the gold standard surgical treatments for this condition, given their safety and effectiveness [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Open surgery, performed through a transvesical, retrovesical, transperineal, or transcoccygeal approach, was historically the first treatment modality that was associated with a high success rate. Nowadays, transurethral, laparoscopic, and robotic-assisted approaches are also performed to treat Zinner’s syndrome [ 5 , 6 ]. Abdominal ultrasound can provide information about the composition, dimensions, and exact location of a mass; the bladder’s integrity; and the presence of ipsilateral renal agenesis or dysgenesis.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Radical Prostatectomy Performed in a Patient With Zinner’s Syndrome: The First Case Described in the Literature

Spinos¹,

Leotsakos²,

Katafigiotis³

et al. 2023

Cureus

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Zinner's syndrome is a rare congenital disorder presenting with unilateral renal agenesis or dysgenesis, ipsilateral seminal vesicle cysts, and ejaculatory duct obstruction. Treatment of this syndrome can be conservative or surgical. In this case report, we describe the case of a 72-year-old patient who was diagnosed with Zinner's syndrome and underwent laparoscopic radical prostatectomy for prostate cancer treatment. The peculiarity of our case was that the patient's ureter emptied ectopically into the left seminal vesicle, which was notably enlarged and multicystic in appearance. Although many minimally invasive procedures have been reported for treating symptomatic Zinner's syndrome, to our knowledge, this is the first reported case of prostate cancer in a patient with Zinner's syndrome who was treated with laparoscopic radical prostatectomy. Laparoscopic radical prostatectomy can be safely and efficiently performed in patients with Zinner's syndrome and synchronous prostate cancer by urological surgeons with extensive experience in laparoscopy in high-volume centers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Radical Prostatectomy Performed in a Patient With Zinner’s Syndrome: The First Case Described in the Literature

Spinos¹,

Leotsakos²,

Katafigiotis³

et al. 2023

Cureus

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“…According to Demaeyer et al, we keep in mind its potential relapse. So this method is suitable but probably shouldn’t be repeated if the desired results are not achieved [ 9 ]. The authors agree that only the surgical excision of the cyst and seminal vesicle is 100% effective.…”

Section: Discussionmentioning

confidence: 99%

“…Less invasive procedures such as conventional laparoscopic surgeries are now suggested. The latest articles also describe robotic-assisted surgeries, but the combination of the rarity of the disease and the inaccessibility of advanced tools such as a robot everywhere results in less than 10 cases described in the literature [ 9 ]. Unfortunately, there is no consensus on the best treatment modality.…”

Section: Discussionmentioning

confidence: 99%

Zinner Syndrome—A Rare Cause of Recurrent Epididymitis and Infertility

Ostrowska¹,

Grześk²,

Kaczyński³

et al. 2021

Clinics and Practice

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Zinner syndrome (ZS) is a rare disorder that affects only men. It is characterized by a triad of abnormalities, including unilateral renal agenesis, ipsilateral seminal vesicle cysts, and atresia of the ejaculatory tract. Unfortunately, there is no consensus on the best treatment modality. We describe a case of a young male patient with recurrent epididymitis, dysuria, and frequent urination. In the diagnostic evaluation, we found an extended right seminal vesicle in the ultrasound with hyperechoic fluid inside and an absence of the right kidney. We performed magnetic resonance imaging, computed tomography, and semen analysis confirming Zinner syndrome and deteriorated semen parameters. Urethroscopic evaluation and ultrasound-guided puncture of the seminal vesicle were performed. An abscess was excluded. The cytologic evaluation showed hemosiderophages. Tamsulosin was introduced. We found no signs of relapse in a six-month observation, and the patient had no further symptoms. Therefore, minimally invasive treatment is a feasible option in young patients found with early-stage Zinner syndrome.

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“…There are reports of open, laparoscopic, and robotically assisted excision of the cysts [4,5], and the patients have all experienced a resolution of their symptoms after treatment. Aspiration of symptomatic cysts, however, tends to lead to recurrence of the symptoms, ultimately requiring surgical excision at a later date [6][7][8]. In patients where infertility was the presenting complaint, transurethral resection of the ejaculatory ducts was attempted [9], with subsequent improvement in semen characteristics.…”

mentioning

confidence: 99%

Long-Term Surveillance and Laparoscopic Management of Zinner Syndrome

Kelly

Fuentes-Bonachera

Shields

et al. 2021

Case Reports in Urology

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Zinner syndrome was first described in 1914 and represents the triad of unilateral renal agenesis and ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. Seminal vesicle cysts are often asymptomatic but can also present with pain, haematospermia, or other lower urinary tract symptoms. Treatment strategies include observation and surgical excision. We present the laparoscopic management of an enlarged seminal vesicle cyst, consistent with Zinner syndrome, 14 years after the initial diagnosis. A 58-year-old male patient was diagnosed with a left-sided seminal vesicle cyst while undergoing assessment for renal transplant due to progressively worsening renal function in his solitary right kidney. The otherwise asymptomatic cyst enlarged from the time of initial diagnosis in 2004 ( 11.3 cm × 9.7 cm × 13.1 cm ) to nearly double the size in 2018 ( 12.8 cm × 11.9 cm × 14.2 cm ). This cyst size ultimately precluded renal transplant, and the patient was referred for excision. Laparoscopic excision of the cyst was performed, histopathology confirmed seminal vesicle cyst tissue, and there has been no recurrence of the cyst to date. The patient remains active on the renal transplant waitlist. Zinner syndrome is a rare syndrome, with the seminal vesicle cysts being managed by observation or surgical excision. We report the longest documented observation of a seminal vesicle cyst, culminating in a safe and successful laparoscopic excision.

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Robotic management of painful Zinner syndrome, case report and review of literature

Cited by 7 publications

References 12 publications

Laparoscopic Radical Prostatectomy Performed in a Patient With Zinner’s Syndrome: The First Case Described in the Literature

Laparoscopic Radical Prostatectomy Performed in a Patient With Zinner’s Syndrome: The First Case Described in the Literature

Zinner Syndrome—A Rare Cause of Recurrent Epididymitis and Infertility

Long-Term Surveillance and Laparoscopic Management of Zinner Syndrome

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