Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report

Zinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed...

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Main Authors: Zaid Sawaftah, Khaled Sawafta, Moath Hattab, Adel Abu Al Rub, Omar Sawafta, Jehad Khamaysa, Humam Emad Rajha, Jana Dibas, Muath Daraghmeh, Yazan Dibas
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043324013785
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author Zaid Sawaftah
Khaled Sawafta
Moath Hattab
Adel Abu Al Rub
Omar Sawafta
Jehad Khamaysa
Humam Emad Rajha
Jana Dibas
Muath Daraghmeh
Yazan Dibas
author_facet Zaid Sawaftah
Khaled Sawafta
Moath Hattab
Adel Abu Al Rub
Omar Sawafta
Jehad Khamaysa
Humam Emad Rajha
Jana Dibas
Muath Daraghmeh
Yazan Dibas
author_sort Zaid Sawaftah
collection DOAJ
description Zinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed with ZS following a 2-month history of urinary frequency, hesitancy, dysuria, and painful ejaculation. Physical examination revealed a left lower abdominal mass, and imaging confirmed the classic findings of ZS, including unilateral renal agenesis, an enlarged seminal vesicle cyst, and an ectopic ureter. Conservative treatment with tamsulosin initially improved symptoms, but due to the cyst's large size and the risk of complications, laparoscopic excision was recommended for definitive management. ZS is often diagnosed late due to nonspecific symptoms, with an average diagnosis age of 29.35 years. MRI is the gold standard for diagnosis, revealing seminal vesicle cysts, renal agenesis, and ejaculatory duct obstruction. Conservative management is reserved for asymptomatic cases, while symptomatic patients benefit from surgical intervention. This case emphasizes the importance of timely imaging, particularly in patients with nonspecific lower urinary tract symptoms, and highlights the role of tamsulosin as an effective interim therapy before definitive surgical treatment. The case underscores the need for clear diagnostic criteria and treatment pathways to improve outcomes in this rare condition, which can lead to infertility if not managed appropriately.
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spelling doaj-art-845ed29438484da4bbd755df5cffbf702025-01-18T05:04:07ZengElsevierRadiology Case Reports1930-04332025-03-0120317211725Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case reportZaid Sawaftah0Khaled Sawafta1Moath Hattab2Adel Abu Al Rub3Omar Sawafta4Jehad Khamaysa5Humam Emad Rajha6Jana Dibas7Muath Daraghmeh8Yazan Dibas9Department of Medicine, An Najah National University, Nablus, PalestineDepartment of Medicine, An Najah National University, Nablus, PalestineDepartment of Medicine, An Najah National University, Nablus, PalestineDepartment of Medicine, An Najah National University, Nablus, PalestineDepartment of Medicine, An Najah National University, Nablus, PalestineDepartment of Radiology, Tubas Turkish Governmental Hospital, Tubas, PalestineCollege of Medicine, QU Health, Qatar University, Doha, QatarDepartment of Medicine, An Najah National University, Nablus, Palestine; Corresponding author.Department of Radiology, Patient's Friends Society, Nablus, PalestineDepartment of Radiology, Makassed hospital, Jerusalem, PalestineZinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed with ZS following a 2-month history of urinary frequency, hesitancy, dysuria, and painful ejaculation. Physical examination revealed a left lower abdominal mass, and imaging confirmed the classic findings of ZS, including unilateral renal agenesis, an enlarged seminal vesicle cyst, and an ectopic ureter. Conservative treatment with tamsulosin initially improved symptoms, but due to the cyst's large size and the risk of complications, laparoscopic excision was recommended for definitive management. ZS is often diagnosed late due to nonspecific symptoms, with an average diagnosis age of 29.35 years. MRI is the gold standard for diagnosis, revealing seminal vesicle cysts, renal agenesis, and ejaculatory duct obstruction. Conservative management is reserved for asymptomatic cases, while symptomatic patients benefit from surgical intervention. This case emphasizes the importance of timely imaging, particularly in patients with nonspecific lower urinary tract symptoms, and highlights the role of tamsulosin as an effective interim therapy before definitive surgical treatment. The case underscores the need for clear diagnostic criteria and treatment pathways to improve outcomes in this rare condition, which can lead to infertility if not managed appropriately.http://www.sciencedirect.com/science/article/pii/S1930043324013785Renal agenesisEjaculatory duct obstructionZinnerSeminal vesicle cystTamsulosin
spellingShingle Zaid Sawaftah
Khaled Sawafta
Moath Hattab
Adel Abu Al Rub
Omar Sawafta
Jehad Khamaysa
Humam Emad Rajha
Jana Dibas
Muath Daraghmeh
Yazan Dibas
Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
Radiology Case Reports
Renal agenesis
Ejaculatory duct obstruction
Zinner
Seminal vesicle cyst
Tamsulosin
title Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
title_full Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
title_fullStr Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
title_full_unstemmed Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
title_short Zinner syndrome unveiled: Ectopic ureter and seminal vesicle cyst leading to urinary dysfunction: A case report
title_sort zinner syndrome unveiled ectopic ureter and seminal vesicle cyst leading to urinary dysfunction a case report
topic Renal agenesis
Ejaculatory duct obstruction
Zinner
Seminal vesicle cyst
Tamsulosin
url http://www.sciencedirect.com/science/article/pii/S1930043324013785
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