以精確手術治療罹患Zinner症候群之年輕男性復發攝護腺旁囊腫
洪紹綸1、吳俊賢1,2、林嘉祥1,2
1義大醫療財團法人義大醫院 泌尿科；
2義守大學 醫學系
Using robotic surgery to treat recurrent paraprostatic cyst in a young man with Zinner syndrome
Leo Shao-Lun Hung1, Chun-Hsien Wu1,2, Victor C. Lin1,2
Department of Urology1, E-Da Hospital, Kaohsiung, Taiwan;
School of Medicine, College of Medicine2, I-Shou University, Kaohsiung, Taiwan
Abstract
Zinner syndrome is a rare congenital malformation characterized by the triad of renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. It is caused by abnormal development of the Wolffian duct between the fourth to thirteenth week of gestational age. The symptoms are usually non-specific and may vary from perianal pain, hematospermia, epididymitis, bladder outlet obstruction to infertility.
A 31-year-old male presented the symptoms progressive voiding difficulty. The initial uroflowmetry showed low flow rate with intermittent voiding pattern and bladder ultrasound revealed a cystic lesion over the bladder neck. The abdominal computed tomography showed right renal agenesis and one paraprostatic retrovesical cyst near the bladder neck causing bladder outlet obstruction. Direct cyst puncture under ultrasound guidance and contrast medium injection revealed the aforementioned lesion was not connected with the urinary tract, and simple aspiration of the cyst was performed initially at the other hospital. However,the lower urinary tract symptoms recurred 12 years later and the patient asked for definitive treatment of the cystic lesion. We conducted the robotic-assisted laparoscopic excision of the pelvic cystic lesion and the pathology report confirmed the diagnosis of the seminal vesicle cyst.