Zinner syndrome

Last revised by Andrew Murphy on 18 Jan 2024

Zinner syndrome is a triad of mesonephric (Wolffian) duct anomalies comprising unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction 1.

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The condition is rare, with ~200 reported cases (c. 2009) 9.

Patients are typically diagnosed during the 3rd or 4th decade of life and often present with perineal pain, recurrent prostatitis, hematospermia, painful ejaculation, and infertility 1.

There is an association between congenital malformations of the seminal vesicle and the ipsilateral upper urinary tract because both the ureteral buds and the 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:

Small testis and ipsilateral ureterocele have also been reported 7 .

In asymptomatic patients, treatment is usually conservative, however, symptomatic patients are often treated surgically 5.

Zinner syndrome was first described by A Zinner in 1914 8.

Seminal vesicle cysts should be differentiated from other cysts such as 4:

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