Ejaculatory duct obstruction caused by a right giant seminal vesicle with an ipsilateral upper urinary tract agenesia: an embryologic malformation.
OBJECTIVE
To report our experience with TURED in infertile men with EDO associated with abnormal development of the mesonephric or Wolffian duct, causing a contemporary malformation of the ipsilateral upper urinary tract.


METHODS
Retrospective clinical study.


METHODS
Infertile men in an hospital environment.


METHODS
Seven patients affected by Zinner syndrome, from March to September 2005, were selected.


METHODS
Underwent TURED.


METHODS
Semen analysis, endocrine profile, transrectal ultrasonography and seminal vesicles aspiration, excretory urography, computerized tomography (CT), or magnetic resonance imaging (MRI).


RESULTS
Before surgery, the patients experienced a decreased intensity and force of ejaculation and a low motile sperm count. The detection of the ipsilateral upper urinary tract malformation by the patients was incidental. After surgery, all patients reported having a projectile ejaculation, an increase in the average postoperative volume, and of the total motile sperm count.


CONCLUSIONS
A seminal vesicle cyst combined with ipsilateral renal agenesis, described as Zinner syndrome, is a rare urological anomaly. It is frequently asymptomatic or else characterized by infertility, symptoms of bladder irritation, or pain in the scrotum and perineum. In selected patients, TURED can improve semen quality with subsequent ability to impregnate. The upper urinary tract malformation should be treated in symptomatic cases only.
Department of Urology, University of L'Aquila, Unit of Urology, Mazzini Hospital, Teramo, Italy. pacegianni@beactive.it
Gianna
G
Pace
Giuseppe Paradiso
GP
Galatioto
Luana
L
Gualà
Guido
G
Ranieri
Carlo
C
Vicentini
D000328:Adult; D004543:Ejaculatory Ducts / Q000196:embryology / Q000473:pathology / Q000601:surgery; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000601:surgery*; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology*; D012189:Retrospective Studies; D012661:Semen / Q000502:physiology; D012669:Seminal Vesicles / Q000002:abnormalities*; D013076:Sperm Count; D013081:Sperm Motility; D014551:Urinary Tract / Q000002:abnormalities*; D013519:Urogenital Surgical Procedures / Q000009:adverse effects