Systematic Review of Zinner syndrome
DOI:
https://doi.org/10.48193/y4nnwq31Keywords:
Zinner syndrome, Congenital Abnormalities, Seminal Vesicles, Unilateral Renal AgenesisAbstract
Zinner syndrome is characterized as a pathology of congenital origin in which there is a unilateral absence of the kidney, presence of cysts and obstruction in the ejaculatory ducts. Being diagnosed in the stage of sexual activity of patients, it can cause problems in the person's sexuality or reproduction. The objective of this work was to carry out a systematic review of clinical cases reported in the literature between 2013 and 2023. 42 reports of clinical cases with Zinner syndrome were evaluated, with a total of 49 patients with a mean age of 22.5 years, the 77.55 % of the patients presented cysts, absence of the right kidney in 44.90 % of the patients, and 91.84 % presented pain. The most common treatment for this pathology was laparoscopy (16.33 %) and in the reviewed cases there were no complications or deaths. Identifying the different presentations of this syndrome could improve the speed of diagnosis and guarantee effective management, thereby improving the quality of life of patients.
References
Kumar S, G KI, Khalil-Khan A, Arul Pitchai ADP, Sathiamoorthy R, Raju E. Zinner Syndrome. Cureus. 2022 Nov 9;14(11):e31308. https://doi.org/10.7759/cureus.31308
Abakar D, Badi FE, Sabiri M, El Manjra S, Lezar S, Essodegui F. Zinner Syndrome. European Journal of Case Reports in Internal Medicine. 2021; 8(7):002628. https://doi.org/10.12890/2021_002628
Randhawa JS, Shankaran R, Nagamahendran R, Upadhye MA, Deepak H. Zinner Syndrome with Papillary Neoplasm: A Rare Case Report. Journal of Indian Association of Pediatric Surgeons. 2022 Jul-Aug;27(4):473-475. https://doi.org/10.4103/jiaps.jiaps_84_21
Regmi AR, Mishra S, Gurung A, Acharya A, Paneru LD, Ghimire A. Zinner's syndrome: A rare diagnosis of congenital seminal vesicle cyst and renal agenesis on basis of radiological imaging and its management. International Journal of Surgery Case Reports. 2022 Aug;97:107434. https://doi.org/10.1016/j.ijscr.2022.107434
Gurung B, Panta OB, Dhakal V, Ghimire RK. Zinner Syndrome: A Case Report of Rare Urogenital Anomaly. Journal of Medical Ultrasound. 2021 May 4;30(1):59-61. https://doi.org/10.4103/jmu.jmu_125_20
Sada F, Cekaj E, Saraci B, Shazi O, Al-Madani A, Jahanian S, et al. Challenging clinical presentation of Zinner syndrome. Radiology Case Reports. 2023 Jan;18(1):256–9. https://doi.org/10.1016/j.radcr.2022.10.006
Foladi N, Nasery MN. Right-sided Zinner syndrome with a left side quadrupled ureter– a case report. Radiology Case Reports. 2021 Oct;16(10):2873–7. https://doi.org/10.1016/j.radcr.2021.06.086
Ostrowska M, Grześk M, Kaczyński S, Skwara D, Kulik K, Kowalski F, Ostrowski A, Drewa T. Zinner Syndrome-A Rare Cause of Recurrent Epididymitis and Infertility. Clinics and Practice. 2021 Dec 9;11(4):942-946. https://doi.org/10.3390/clinpract11040108
Rahoui M, Ouanes Y, Chaker K, Bibi M, Mrad Dali K, Sellami A, Ben Rhouma S, Nouira Y. An unusual cause of painful ejaculation in a young patient: Zinner syndrome. Annals of Medicine and Surgery. 2022 Jun 10;79:103982. https://doi.org/10.1016/j.amsu.2022.103982
Ansari FM, Para SA, Singh S, Wani MS, Bhat AH, Maurya MK. Zinner’s syndrome: Masquerading as pyonephrotic ectopic kidney. Radiology Case Reports. 2023 Jan;18(1):131–4. https://doi.org/10.1016/j.radcr.2022.09.060
Canales-Casco N, Dominguez-Amillo A, Arrabal-Polo MA, Sanchez-Tamayo FJ, Arrabal-Martin M, Cozar-Olmo JM. Hematospermia as a Rare Form of Presentation of Zinner Syndrome. Urology. 2017 Jan;99:e15–6. https://doi.org/10.1016/j.urology.2016.09.030
Beyene E, Tadele E, Negassa M. Zinner syndrome: A first case report from Ethiopia. Radiology Case Reports. 2023 Jan;18(1):86–90. https://doi.org/10.1016/j.radcr.2022.09.074
Almofareh AM, Aljuaid KM, Almirabi SA, Hakami YM, Alwan AM. Zinner Syndrome: A Case Report of a Rare Etiology of Infertility. Cureus. 2021 Aug 23;13(8). https://doi.org/10.7759/cureus.17386
Kori R, Bains L, Lal P, Gupta S. Zinner syndrome mimicking bladder outlet obstruction managed with aspiration. Urology Annals. 2019 Oct-Dec;11(4):449-452. https://doi.org/10.4103/ua.ua_152_18
Almuhanna AM, Alsuhaibani S, Almesned R, Almatar A, Alali H. Zinner’s syndrome: Case report of a rare maldevelopment in the male genitourinary tract. Urology Case Reports. 2021 Nov;39:101839. https://doi.org/10.1016/j.eucr.2021.101839
Maehana T, Fukuta F, Kobayashi K, Hirobe M, Tanaka T, Masumori N. Laparoscopic Surgery for Seminal Vesicle Cysts and Ureterocele with Urination Disorder: A Case Report of Zinner Syndrome. Journal of Endourology Case Reports. 2018 May;4(1):35–8. https://doi.org/10.1089/cren.2018.0008
Kwenda EP, Locke RA, Archer JS, Su LM, Shenoy A, DeMarco RT, et al. Robot-Assisted Laparoscopic Resection of the Mesonephric Duct Remnant in a Patient with Zinner Syndrome. Journal of Endourology Case Reports. 2020 Sep 1;6(3):198–201. https://doi.org/10.1089/cren.2020.0020
Ibrahimi A, Hosni A, Ziani I, Laamrani FZ, El Sayegh H, Jroundi L, et al. Zinner’s Syndrome: A Rare Diagnosis of Dysuria Based on Imaging. Case Reports in Urology. 2020 Dec 7;2020:1–6. https://doi.org/10.1155/2020/8826664
Florim S, Oliveira V, Rocha D. Zinner syndrome presenting with intermittent scrotal pain in a young man. Radiology Case Reports. 2018 Sep 20;13(6):1224-1227. https://doi.org/10.1016/j.radcr.2018.08.012
Marzocchi G, D’Onofrio R, Branchini M, Lovato L. Unilateral scrotal discomfort in a patient with known renal agenesis: do not forget about Zinner syndrome. BMJ Case Reports. 2022 Jan;15(1):e248468. https://doi.org/10.1136/bcr-2021-248468
Shah S, Patel R, Sinha R, Harris M. Zinner syndrome: an unusual cause of bladder outflow obstruction. BJR Case Reports. 2017 Jun;3(2):20160094. https://doi.org/10.1259/bjrcr.20160094
Sundar R, Sundar G. Zinner syndrome: an uncommon cause of painful ejaculation. BMJ Case Reports. 2015 Mar 6;2015(mar06 1):bcr2014207618–8. https://doi.org/10.1136/bcr-2014-207618
Khoda J, Sen S, Chatterjee A. Incidental detection of Zinner syndrome in a patient with nonseminomatous germ cell tumor of testis. Urology Annals. 2020 Oct-Dec;12(4):394-395. https://doi.org/10.4103/ua.ua_11_20.
Smith JS, Springhart WP. Ejaculatory Duct Obstruction in the Setting of an Ectopic Ureter. Sexual Medicine. 2020 May 18;8(3):574–6. https://doi.org/10.1016/j.esxm.2020.03.004
Hergan B, Fellner FA, Akbari K. Incidental imaging findings suggesting Zinner syndrome in a young patient with pulmonary embolism: A case report. Radiology Case Reports. 2020 Apr;15(4):437–41. https://doi.org/10.1016/j.radcr.2020.01.027
Symeonidis EN, Gkekas C, Tsifountoudis I, Symeonidis A, Georgiadis C, Kalyvas V, et al. Incidental finding of Zinner syndrome in a Greek military recruit: a case report of a rare clinical entity. Military Medical Research. 2019 Feb 14;6(1). https://doi.org/10.1186/s40779-019-0194-9
Campora M, Olivero A, Toncini C, Spina B, Fulcheri E, Terrone C, et al. Zinner Syndrome: A Diagnostic Challenge. The Aid of Morphology, Embryology, and Immunohistochemistry. Urology. 2017 Oct;108:e3–5. https://doi.org/10.1016/j.urology.2017.06.013
Cito G, Gemma L, Giachini C, Micelli E, Cocci A, Fucci R, Picone R, Sforza S, Nesi G, Santi R, Minervini A, Masieri L, Carini M, Coccia ME, Natali A. Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome. Clinical and Experimental Reproductive Medicine. 2021 Mar;48(1):85-90. https://doi.org/10.5653/cerm.2020.03769
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. Scandinavian Journal of Urology. 2016 Dec;51(1):81–4. https://doi.org/10.1080/21681805.2016.1257650
AlArifi M, Al-Gahwary M, Gomha M. The Association of Renal Agenesis and Ipsilateral Seminal Vesicle Cyst: Zinner Syndrome Case Report. Case Reports in Urology. 2019 Jun 23;2019:1–3. https://doi.org/10.1155/2019/1242149
Mehra S, Ranjan R, Garga UC. Zinner syndrome—a rare developmental anomaly of the mesonephric duct diagnosed on magnetic resonance imaging. Radiology Case Reports. 2016 Dec;11(4):313–7. https://doi.org/10.1016/j.radcr.2016.04.002
Gorantla R, Allu S, Rao A. A Triad of Unilateral Renal Dysgenesis with Ipsilateral Seminal Vesical and Ejaculatory Duct Obstruction: An Uncommon Urogenital Congenital Anomaly, Zinner Syndrome—A Case Report. Indian Journal of Radiology and Imaging. 2021 Jul;31(03):707–9. https://doi.org/10.1055/s-0041-1735503
Kord E, Zisman A, Darawsha AE, Dally N, Noh PH, Neheman A. Minimally Invasive Approach for Treatment of Seminal Vesicle Cyst Associated with Ipsilateral Renal Agenesis. Urologia Internationalis. 2017;99(3):338–42. https://doi.org/10.1159/000464298
Farooqui A, AlDhahir L, Mahfooz AB. Massive seminal vesicle cyst with ipsilateral renal agenesis - Zinner syndrome in a Saudi patient. Urology Annals. 2018 Jul-Sep;10(3):333-335. https://doi.org/10.4103/ua.ua_17_18
Haddock P, Wagner JR. Seminal Vesicle Cyst With Ipsilateral Renal Agenesis and Ectopic Ureter (Zinner Syndrome). Urology. 2015 May;85(5): e41–2. https://doi.org/10.1016/j.urology.2015.02.015
Cito G, Sforza S, Gemma L, Cocci A, Di Maida F, Dabizzi S, et al. Infertility case presentation in Zinner syndrome: Can a long‐lasting seminal tract obstruction cause secretory testicular injury? Andrologia. 2019 Oct 7;51(11). https://doi.org/10.1111/and.13436
Ghonge N, Aggarwal B, Sahu A. Zinner syndrome: A unique triad of mesonephric duct abnormalities as an unusual cause of urinary symptoms in late adolescence. Indian Journal of Urology. 2010;26(3):444. https://doi.org/10.4103/0970-1591.70592
Khanduri S, Katyal G, Sharma H, Goyal A, Singh N, Yadav H. Unique Association of Multiple Seminal Vesicle Cysts with Contralateral Renal Agenesis: A Rare Variant of Zinner Syndrome. Cureus. 2017 Jul 1; 9(7). https://doi.org/10.7759%2Fcureus.1415
Aghaways I, Ahmed SM. Endourologic Intervention for Management of Infertility in a Man with Zinner Syndrome Resulting in a Natural Pregnancy. Journal of Endourology Case Reports. 2016 Dec;2(1):71–3. https://doi.org/10.1089/cren.2016.0010
Razdan S, Kryvenko ON, Razdan S. Robotic-assisted laparoscopic vesiculectomy in a patient with atypical Zinner syndrome presenting with large cyst involving bilateral seminal vesicles and vasa deferentia. Urology Case Reports. 2018 May; 18:79–81. https://doi.org/10.1016/j.eucr.2018.03.014
