A Rare Cause of Chronic Pelvic Pain in Young Man: Magnetic Resonance Imaging Findings of Zinner’s Syndrome

Chronic pelvic pain is more uncommon in men than in women, and it is often thought to be due to problems with the urogenital system. The maldevelopment of the urogenital system is a rare condition, and frequently detected incidentally. Zinner’s syndrome is a rare urogenital system development anomaly comprising a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. Patients with this anomaly are often asymptomatic until the second or third decade of life. Some patients present with non-specific symptoms, such as prostatism, frequent micturition, recurrent urinary tract infections, painful ejaculation, and chronic pelvic pain. Here, we present the magnetic resonance imaging findings in a 27-year-old patient who had experienced pelvic pain for two years and was diagnosed with Zinner’s syndrome in our clinic.

Genç Erkekte Kronik Pelvik Ağrının Nadir Bir Nedeni: Zinner Sendromunun Manyetik Rezonans Görüntüleme Bulguları

Erkeklerde kronik pelvik ağrı kadınlara göre daha nadir olarak görülür, sıklıkla ürogenital sistem kaynaklı olduğu düşünülmektedir. Ürogenital sistemin gelişimsel anomalileri nadirdir ve sıklıkla tesadüfen tespit edilir. Zinner sendromu, tek taraflı böbrek agenezisi, aynı taraflı seminal vezikül kistleri ve ejakülatör kanal tıkanıklığını içeren nadir bir ürogenital sistem gelişme anomalisidir. Bu anomali sıklıkla yaşamın ikinci veya üçüncü dekadına kadar asemptomatiktir. Bazı olgularda prostatizm, sık idrara çıkma ihtiyacı, tekrarlayan idrar yolu enfeksiyonları, ağrılı boşalma ve kronik pelvik ağrı gibi spesifik olmayan semptomlar vardır. Biz burada, iki yıldır pelvik ağrı şikayeti olan ve tarafımızca Zinner sendromu tanısı alan 27 yaşındaki hastada, manyetik rezonans görüntüleme bulgularını sunmayı amaçladık.

Kaynakça

1. Pereira BJ, Sousa L, Azinhais P, Conceição P, Borges R, Leão R, Brandão A, Temido P, Retroz E, Sobral F. Zinner’s syndrome: an up-to-date review of the literature based on a clinical case. Andrologia 2009;41:322-330.

2. Zinner A . Ein fall von intravesikaler samenblasenzyste. Weien Med Wschr 1914;64:604–610.

3. Gianna P, Giuseppe PG. Mayer-Rokitansky-Kuster-Hauser syndrome and the Zinner syndrome, female and male malformation of reproductive system: are two separate entities? J Chinese Clin Med 2007;2:11.

4. Kao CC, Wu CJ, Sun GH, Yu DS, Chen HI, Chang SY, Ma CP, Cha TL. Congenital seminal vesicle cyst associated with ipsilateral renal agenesis mimicking bladder outlet obstruction: a case report and review of the literature. Kaohsiung J Med Sci 2010;26:30-34.

5. Livingston L, Larson CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol 2000;175:177-180.

6. Arora SS, Breiman RS, Webb EM, Westphalen AC, Yeh BM, Coakley FV. CT and MRI of congenital anomalies of the seminal vesicles. Am J Roentgenol 2007;189:130-135.

7. Kosan M, Tul M, Inal G, Ugurlu O, Adsan O. A large seminal vesicle cyst with contralateral renal agenesis. Int Urol Nephrol 2006;38:591-592.

8. Kenney PJ, Leeson MD. Congenital anomalies of the seminal vesicles: spectrum of computed tomographic findings. Radiology 1983;149:247- 251.

9. Trigaux JP, Van Beers B, Delchambre F. Male genital tract malformations associated with ipsilateral renal agenesis: sonographic findings. J Clin Ultrasound 1991;19:3e10.

10. Cihan A, Cimen S, Secil M, Kefi A, Aslan G. Congenital seminal vesicle cyst accompanying ipsilateral renal agenesis and rudimentary ureter. Int Urol Nephrol 2006;38:133-135.

11. Sundar R, Sundar G. Zinner syndrome: an uncommon cause of painful ejaculation. BMJ Case Rep 2015:2015.

12. King BF, Hattery RR, Lieber MM, Berquist TH, Williamson B Jr, Hartman GW. Congenital cystic disease of the seminal vesicle. Radiology 1991;178:207- 211.

Kaynak Göster

  • ISSN: 2148-9580
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2014

4.4b2.8b

Sayıdaki Diğer Makaleler

Evaluation of Diabetic Women in Terms of Lower Urinary Tract Symptoms, Overactive Bladder and Urinary Incontinence

Fatih BIÇAKLIOĞLU, Murat Yavuz KOPARAL, Ender Cem BULUT, İrfan Şafak BARLAS, Bora KÜPELİ, İlker ŞEN

Impact of Chronic Constipation on Lower Urinary Tract Symptoms and Uroflowmetry Parameters in Men

Tarık YONGUÇ, Volkan ŞEN, Halil İbrahim BOZKURT, Mehmet Erhan AYDIN, Salih POLAT, Serkan YARIMOĞLU

Paratesticular Solitary Fibrous Pseudotumor and a Brief Literature Review

Ali Furkan BATUR, Mehmet KAYNAR, Zeliha Esin CELIK, Serdar GÖKTAŞ

Secondary Tumors of the Prostate

Havva ERDEM

Current Status of Urological Surgery Clinical Trials in the Middle East and Its Analysis in Comparison to Global

Fatih ÖZDENER, Alihan SURSAL, Fehmi NARTER

Accuracy and Delay of Using Ultrasound in Testicular Torsion

Michael CHEN, Rachel ESLER

Comparison of Efficacy and Safety of Isolated Single Different Calyx Accesses in Percutaneous Nephrolithotomy

Mutlu DEĞER, Volkan İZOL, Fesih OK, Yıldırım BAYAZIT, Nihat SATAR, İbrahim Atilla ARIDOĞAN

Does Increased Stone-skin Distance Due to Obesity Affect Outcomes of Percutaneous Nephrolithotomy?

Batuhan ERGANİ, Mustafa KARABIÇAK, Hakan TÜRK, Mehmet YOLDAŞ, Cemal Selçuk İŞOĞLU, Tufan SÜELÖZGEN, Gökhan KOÇ, Yusuf Özlem İLBEY

Varicocelectomy in Patients with Non-obstructive Azoospermia

Cevahir ÖZER, Mehmet Reşit GÖREN, Ümit GÜL, Tahsin TURUNÇ, Sezgin GÜVEL

A Rare Cause of Adrenal Mass: Adrenocortical Oncocytoma

Serdar ASLAN, Mehmet Selim NURAL