Zinner syndrome: an uncommon cause of painful ejaculation

Abstract

Zinner syndrome refers to the triad of ipsilateral renal agenesis, seminal vesicle cysts and ejaculatory duct obstruction. Ipsilateral renal agenesis may be associated with seminal vesicle cysts in 70% of cases, but a remnant ureteral bud has been shown to coexist in only 27% of these cases. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction: voiding or ejaculatory difficulty or pain. The diagnosis is made with imaging findings, and differentiation from other pelvic cysts requires a multimodality approach. In this report, we present typical imaging findings of a patient who presented with painful ejaculation where there was a congenital seminal vesicle cyst with ipsilateral renal agenesis associated with a remnant ureteral bud draining into the seminal vesicle cyst and also associated with a cyst of the prostatic utricle. We discuss the relevant embryological basis for this unusual combination of findings.

A Rare Cause of Chronic Pelvic Pain in Young Man: Magnetic Resonance Imaging Findings of Zinner’s Syndrome

“…The main differentiation is usually based upon the location: median, para-median, or lateral. In addition, accompanying developmental abnormalities (renal agenesis or anomalies of the external genitalia) may help the differential diagnosis (11). Vesical diverticula are para-median, ejaculatory duct cysts are midline in location.…”

Congenital Seminal Vesicle Cyst and Ipsilateral Renal Agenesis (Zinner Syndrome): A Rare Association and Its Evolution from Early Childhood to Adolescence

“…Larger cysts can irritate the bladder and be related to pain, dysuria, frequency, hematuria, urinary tract infection, epididymitis or prostatitis, infertility, hemospermia, bladder outlet, or colonic obstruction. 1 2 6 Malignant degeneration of the cysts has been also reported. 2 4 …”

Zinner’s Syndrome: Case Report of a Rare Maldevelopment in the Male Genitourinary Tract

“…Differential diagnosis involves several cystic diseases of other pelvic organs, including prostatic utricle cysts, ejaculatory duct cysts, prostatic cysts, diverticula of ampulla of vas deferens, ureteroceles, and abscess. Cyst location and other developmental abnormalities (renal agenesis or anomalies of the external genitalia) help to make the differential diagnosis (4,8).…”