V9-12: Fertility recovery after laparoscopic removal of hypertrophic seminal vesicle
Zinner syndrome is a rare condition which include unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. It is generally diagnosed during the third or the fourth decade of life. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction. Invasive treatment should be restricted to symptomatic cases. We present a case of fertility recovery after surgical treatment.
A 20-year-old man presented with azoospermia and perineal discomfort. An abdominal ultrasound documented a left kidney agenesis and a MRI confirmed the presence of left seminal vesicle cyst. The patient qualified for laparoscopic removal of the left seminal vesicle cyst because of persistent pain.
The procedure lasted 145 minutes, with no intra operative complications. The estimated blood loss was 40 mL. The patient was discharged from the hospital on the third postoperative day. Histopathologic examination confirmed the dysgenetic nature of the left seminal vesicle. At the 6-months follow-up the patient was asymptomatic. At the sperm analysis we found a fertility recovery with 1.8 millions sperms with 88% motility.
Zinner syndrome is uncommon and should be treated only in symptomatic cases. This case suggest that surgical treatment could have a role in fertility recovery, probably due to a contralateral compression of seminal ducts. Our experience confirm that laparoscopic approach is a valid, non-traumatic, safe removal technique.