Zinner Syndrome with Chronic Refractory Lower Urinary Tract Symptoms: A Case Report

Zinner syndrome is a rare congenital urogenital anomaly characterized by unilateral renal agenesis, ejaculatory duct obstruction and ipsilateral seminal vesicle cyst due to developmental arrest in early embryogenesis affecting the caudal end of Mullerian duct. Here, we report a case of 27-year-old male, who presented with burning micturition, pain at base of penis, painful ejaculation and painful defecation for 10 years with history of recurrent urinary tract infection. Physical examination, transrectal ultrasonography, and pelvic magnetic resonance imaging (MRI) showed right renal agenesis, ipsilateral ejaculatory duct obstruction and right seminal vesicle cyst. He was found refractory to the conservative management of 6 months duration. Transurethral resection of veru with right ejaculatory duct and deroofing of the right seminal vesicle cyst was done with bipolar loop. The patient was symptomatically better during the follow-ups. The cases of Zinner syndrome have been addressed adequately but we had not found such cases from Nepal.