Laparoscopic management of congenital seminal vesicle cysts associated with ipsilateral renal agenesis.
OBJECTIVE
Congenital cysts of the seminal vesicles associated with ipsilateral renal abnormalities are rare. When they are symptomatic, open surgical excision has been the treatment of choice. We present our experience with laparoscopic management and provide a detailed literature review of this entity.


METHODS
Since 1985, 3 patients with symptomatic seminal vesicle cysts and ipsilateral renal agenesis have been treated at our center. Open surgical excision was performed in 1 patient and laparoscopic management was performed in the other 2.


RESULTS
Mean patient age was 35.7 years (range 30 to 42). Presenting symptoms were perineal pain in all 3 cases, dysuria in 2, irritable voiding in 2 and testicular pain in 1. Mean laparoscopic operative time was 195 minutes and mean estimated blood loss was 325 cc. Transabdominal or transrectal ultrasound was performed in 2 cases and computerized tomography was performed in all 3.


CONCLUSIONS
Seminal vesicle cysts associated with ipsilateral renal agenesis are rare but they should be considered in men with otherwise inexplicable irritable voiding symptoms, perineal discomfort or other genitourinary complaint of unclear etiology. Evaluation should include digital rectal examination, transrectal and transabdominal ultrasound, computerized tomography and cystoscopy. Laparoscopy provides excellent intraoperative access and visualization with minimal postoperative morbidity. It is likely to become the treatment of choice for this rare developmental anomaly.
Cherullo
Edward E
EE
Section of Laparoscopic and Minimally Invasive Surgery and Section of Male Infertility, Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Meraney
Anoop M
AM
Bernstein
Leonard H
LH
Einstein
David M
DM
Thomas
Anthony J
AJ
Gill
Inderbir S
IS
D000328:Adult; D003560:Cysts / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D003952:Diagnostic Imaging; D005832:Genital Diseases, Male / Q000601:surgery; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D012669:Seminal Vesicles