Incidental Detection of Left-Sided Zinner Syndrome in a Patient with Hematuria – First Ever Case Presentation In Latvia

  • Aleksandrs Dorogojs (Speaker)
  • Alberts Belovs (Co-author)
  • Baiba Ledaine (Co-author)
  • Lietuvietis, V. (Co-author)

Activity: Talk or presentation types › Poster presentation

Description

First discovered in 1914 Zinner syndrome is a very rare condition (200 cases reported) caused by compromised embryologic development of the Wolffian (mesonephric) duct. The congenital anomaly is a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and an ejaculatory duct obstruction, more commonly diagnosed on the right side of the body. Patients are often misdiagnosed which can lead to constant perineal pain or even infertility.A 26-year-old male patient was admitted to the emergency department with complaints of hematuria and dysuria after unprotected coitus. He was referred to the urologist. Basic laboratory tests were done which showed no deviation of normal values except for serum creatinine (122 mmol/l). STD panel was positive for Chlamydia infection. Ultrasound of abdomen revealed first grade hydronephrosis. Next, non-enhanced CT scan showed an absence of the left kidney, enlarged right kidney and an enlarged left seminal vesicle permeating into the urinary bladder. Patient was discharged from the hospital with recommendations that included antibacterial therapy for chlamydiosis, MRI of small pelvis with intravenous contrast, repeated visit with the urologist to perform a lower urinary tract endoscopy. MRI scan revealed enlargement of left seminal vesicle with cystic inclusion containing hemorrhagic substance, creating a permeation in urinary bladder, ejaculatory duct was enlarged as well. During the lower urinary tract endoscopy, a large bump was seen on the left side of urinary bladder which correlated with the findings in MRI, also no signs of left ureteral opening were observed. Diagnosis of Zinner syndrome was made and patient was discharged with recommendations for further treatment plan with surgery as an option.. .. .. This case report highlights a rare case in Latvia, presenting high infertility potential if left untreated. Rareness of this syndrome presents diagnostic difficulties for practicing radiologists and urologists.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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