Rahoui Moez, Ouanes Yassine, Chaker Kays, Bibi Mokhtar, Mrad Dali Kheireddine, Sellami Ahmed, Ben Rhouma Sami, Nouira Yassine
Urology Department La Rabta Hospital, Tunis, Tunisia.
Ann Med Surg (Lond). 2022 Jun 10;79:103982. doi: 10.1016/j.amsu.2022.103982. eCollection 2022 Jul.
and importance: Zinner syndrome is a rare congenital malformation of the seminal vesicles and the homolateral upper urinary tract. While the majority of patients remain asymptomatic and are discovered incidentally, others present symptoms such as micturition or ejaculatory difficulties, or pain. We report a case of Zinner syndrome in a 32-year-old patient with painful ejaculation and discuss the diagnosis and treatment difficulties.
A 32-year-old married patient was consulted for pelvic pain associated with painful ejaculation that had been evolving for six months. The clinical examination was normal. Routine laboratory studies of blood and urine were normal. The patient was explored by ultrasound which showed the absence of the right kidney and the presence of a 7 cm right lateral prostatic cystic mass. On MRI, the right kidney was not visualized. Multiple cysts were seen in the right seminal vesicle. Surgical excision of the cyst by laparotomy was performed. The patient had an uneventful recovery and was discharged on the third postoperative day.
Congenital malformations of the seminal vesicles are often associated with those of the ipsilateral upper urinary tract, as the ureteral and seminal vesicle buds originate from the mesonephric duct. The syndrome often occurs in the second and third decades of life, especially after the onset of sexual activity. The most common symptoms were dysuria, perineal pain, epididymitis, and painful ejaculation. Diagnostic modalities include ultrasound, MRI, and cystoscopy. In patients with symptoms, the therapeutic management of the cyst includes ultrasound-guided aspiration and laparoscopic or open surgical excision.
Seminal vesicle cysts associated with homolateral renal agenesis or hypoplasia are a rare urologic anomaly. The treatment depends on the patient's symptoms. surgical excision of seminal vesicle cysts may be needed for large cysts causing obstructive symptoms.
及重要性：津纳综合征是一种罕见的精囊和同侧上尿路先天性畸形。虽然大多数患者无症状，是偶然发现的，但其他患者会出现排尿或射精困难、疼痛等症状。我们报告一例32岁射精疼痛患者的津纳综合征病例，并讨论诊断和治疗难点。
一名32岁已婚患者因与射精疼痛相关的盆腔疼痛前来就诊，该症状已持续6个月。临床检查正常。血液和尿液的常规实验室检查均正常。对患者进行超声检查，显示右肾缺如，右侧前列腺有一个7厘米的囊性肿块。在磁共振成像（MRI）上，未发现右肾。右精囊内可见多个囊肿。通过剖腹手术对囊肿进行了切除。患者恢复顺利，术后第三天出院。
精囊先天性畸形常与同侧上尿路畸形相关，因为输尿管芽和精囊芽均起源于中肾管。该综合征常发生在人生的第二个和第三个十年，尤其是在性活动开始后。最常见的症状是排尿困难、会阴疼痛、附睾炎和射精疼痛。诊断方法包括超声、MRI和膀胱镜检查。对于有症状的患者，囊肿的治疗方法包括超声引导下抽吸以及腹腔镜或开放手术切除。
与同侧肾缺如或发育不全相关的精囊囊肿是一种罕见的泌尿系统异常。治疗取决于患者的症状。对于引起梗阻症状的大囊肿，可能需要手术切除精囊囊肿。
