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SAGE Open Medical Case Reports 2023Zinner syndrome is a rare congenital malformation characterized by ipsilateral renal agenesis, atresia of the ejaculatory duct, and cystic distension of the seminal...
Zinner syndrome is a rare congenital malformation characterized by ipsilateral renal agenesis, atresia of the ejaculatory duct, and cystic distension of the seminal vesicles. Symptoms typically arise in adolescence or adulthood and may include painful urination, perineal discomfort, and post-ejaculatory pain. Diagnosis, often made between the ages of 20 and 50 years, involves differentiating Zinner syndrome from other cystic disorders using techniques such as cystoscopy, MRI, intravenous urography, and transrectal ultrasound. Treatment varies based on symptom severity, ranging from conservative approaches to invasive surgeries. Regular follow-up is essential to identify complications and preserve fertility. Herein, we present a 27-year-old male with recurrent scrotal swelling and erythema incidentally diagnosed with Zinner syndrome. The patient had a history of recurrent epididymitis and was found to have cystic dilatation of the seminal vesicle, ipsilateral renal agenesis, and obstruction of the left ejaculatory duct on imaging. Given the patient's mild symptoms, he was managed conservatively with antibiotics and pain medication, resulting in significant improvement.
PubMed: 37711962
DOI: 10.1177/2050313X231200111 -
BMC Surgery Dec 2023To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome.
PURPOSE
To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome.
MATERIALS AND METHODS
A retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy.
RESULTS
The total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010).
CONCLUSIONS
The Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.
Topics: Male; Humans; Seminal Vesicles; Hemospermia; Retrospective Studies; Ejaculatory Ducts; Calculi; Cysts
PubMed: 38129847
DOI: 10.1186/s12893-023-02290-2