Evaluation and surgical management by Robotic assisted seminal vesical cyst excision & cystourethroscopy

A 24 years male presented with C/O pain while ejaculation 01 month, H/o k/c/o absent right kidney, H/o penile pain, H/o perineal area pain & Dysuria, no H/O any urinary complaints & fever. Few well defined cystic lesion, largest 42-41mm with echogenic debris within it & it is seen communicating with right ureter ? Ureterocele /? Seminal vesicle cyst. Right kidney is absent. Pancake appearance of right adrenal gland seen. T2 hypointense non enhancing cystic lesion showing T1 hyperintensity seen in right side of pelvis abutting right VUJ & seminal vesicle & measuring 41x47mm. Dilatation of B/L ejaculation ducts seen ? Due to obstruction. after proper pre anesthetic clearness Robotic assisted right seminal vesical cyst wall excision was done & right ureter was ligated near the VUJ, intra operatively bladder wall was opened which was repaired in two lyres. Post operate period was event full, drain was removed on day 03. patient was discharged on day 04 on full oral diet.

 

Zinner syndrome is a wolffian duct abnormality comprisinga triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Less than 200 cases reported in the literature. The association between upper urinary tract abnormalities and seminal vesicle malformation are based on the shared origin of the ureteral buds and seminal vesicles from the mesonephric (Wolffian) duct.