Patients are typically diagnosed at 3rd or 4th decade of life and often present with perineal pain, recurrent prostatitis, haematospermia, painful ejaculation, and infertility 1.
There is an association between congenital malformations of the seminal vesicle and ipsilateral upper urinary tract because both ureteral buds and seminal vesicles originate from the mesonephric (Wolffian) duct 2,3.
Maldevelopment of the distal part of the mesonephric duct results in atresia of the ejaculatory duct (leading to obstruction and dilatation of the seminal vesicle), while an abnormality in the ureteral bud leads to renal agenesis/dysplasia 1.
Irrespective of imaging modality, the key findings are 1:
- unilateral renal agenesis
- ipsilateral ejaculatory duct obstruction
- ipsilateral seminal vesicle cyst
Treatment and prognosis
In asymptomatic patients, treatment is usually conservative, however, symptomatic patients are often treated surgically 5.
Seminal vesicles should be differentiated from other cysts such as 4
- 1. Ghonge NP, Aggarwal B, Sahu AK. Zinner syndrome: A unique triad of mesonephric duct abnormalities as an unusual cause of urinary symptoms in late adolescence. Indian J Urol. 2010;26 (3): 444-7. doi:10.4103/0970-1591.70592 - Free text at pubmed - Pubmed citation
- 2. Livingston L, Larsen CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol. 2000;175 (1): 177-80. doi:10.2214/ajr.175.1.1750177 - Pubmed citation
- 3. Denes FT, Montellato NI, Lopes RN et-al. Seminal vesicle cyst and ipsilateral renal agenesis. Urology. 1986;28 (4): 313-5. Pubmed citation
- 4. Kuo J, Foster C, Shelton DK. Zinner's Syndrome. World J Nucl Med. 2011;10 (1): 20-2. doi:10.4103/1450-1147.82115 - Free text at pubmed - Pubmed citation
- 5. Seo IY, Kim HS, Rim JS. Congenital seminal vesicle cyst associated with ipsilateral renal agenesis. Yonsei Med. J. 2009;50 (4): 560-3. doi:10.3349/ymj.2009.50.4.560 - Free text at pubmed - Pubmed citation
- 6.5. Naval-Baudin P, Carreño García E, Sanchez Marquez A, Valcárcel José J, Romero NM. Multicystic seminal vesicle with ipsilateral renal agenesis: two cases of Zinner syndrome. Scand J Urol 2017;51:81–4. -Pubmed citation