Zinner's Syndrome:Report of two cases with different symptoms managed by minimally invasive approach

Abstract

Abstract Background: Zinner’s syndrome is characterized by triad of seminal vesicle cysts with ipsilateral renal agenesis and ejeculatory duct obstruction. It sometimes becomes symptomatic during reproductive time of the patient. In this article,we present a minimally invasive approach for two patients with Zinner syndrome. Case presentation: First patient was 37 years old man with 5 years history of infertility. Semen analysis was typical for obstructive azoospermia and ultrasonography revealed the absence of left kidney and anechoic pelvic mass with a thick wall. MRI confirmed Zinner’s syndrome showing 9 cm sized seminal vesicle cyst on the posterior of the bladder. The second patient was 18 years old boy with one year history of abdominal-pelvic pain and lower urinary tract symptoms. Ultrasonography revealed the absence of right kidney and fluid-filled cystic lesion behind the bladder. Contrast enhanced CT confirmed Zinner’s syndrome diagnosis showing solitary left kidney with 8 cm sized seminal vesicle cyst on the posterior of the bladder. We performed laparoscopic seminal vesicle cyst excision for both patient successfully. The procedure was performed with transperitoneal access using four trocars for two patients. Conclusions: Laparoscopic approach for seminal vesicle cysts is feasible because it provides quicker recovery and less morbidity. Therefore it should be considered for treating seminal vesicle cysts.