Zinner Syndrome-A Rare Cause of Recurrent Epididymitis and Infertility

Abstract

Zinner syndrome (ZS) is a rare disorder that affects only men. It is characterized by a triad of abnormalities, including unilateral renal agenesis, ipsilateral seminal vesicle cysts, and atresia of the ejaculatory tract. Unfortunately, there is no consensus on the best treatment modality. We describe a case of a young male patient with recurrent epididymitis, dysuria, and frequent urination. In the diagnostic evaluation, we found an extended right seminal vesicle in the ultrasound with hyperechoic fluid inside and an absence of the right kidney. We performed magnetic resonance imaging, computed tomography, and semen analysis confirming Zinner syndrome and deteriorated semen parameters. Urethroscopic evaluation and ultrasound-guided puncture of the seminal vesicle were performed. An abscess was excluded. The cytologic evaluation showed hemosiderophages. Tamsulosin was introduced. We found no signs of relapse in a six-month observation, and the patient had no further symptoms. Therefore, minimally invasive treatment is a feasible option in young patients found with early-stage Zinner syndrome.

Keywords: Zinner syndrome; epididymitis; infertility; kidney agenesis.

Figure 1

CT scan with contrast showing left kidney and absence of right kidney.

Figure 2

Enlarged seminal vesicle is pointed by the white arrow: (A) CT axial plane, (B) MRI axial plane, (C) CT frontal plane, (D) MRI frontal plane, (E) CT longitudinal plane, and (F) MRI longitudinal plane.