Robot-assisted vesiculectomy for Zinner syndrome

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Abstract

The association of congenital cysts of seminal vesicles with unilateral renal agenesis and obstruction of the vas deferens was first described by A.Zinner in 1914. Later, the combination of these anomalies was called Zinner’s syndrome. Zinner’s syndrome occurs in just over 200 cases out of 100,000 patients and includes a triad of symptoms: cystic formation of the seminal vesicle, obstruction of the vas deferens and ipsilateral renal agenesis. Zinner’s syndrome is most often asymptomatic until the third or fourth decade of life, and symptoms usually appear with the onset of sexual activity. Patients usually have non-specific symptoms such as problems urinating, pain in the perineum, possible hematuria, recurrent urinary tract infections, and painful ejaculation. Infertility caused by obstruction of the vas deferens is also common. The severity of the symptoms is associated with an increase in cyst size. Minimally invasive interventions such as traditional laparoscopy or robot-assisted surgery are safe and effective and should currently be considered the gold standard of treatment. In the framework of this work, we present a clinical case of treatment of a patient with Zinner’s syndrome.

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About the authors

Armais A. Kamalov

Lomonosov Moscow State University; GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Email: armais.kamalov@rambler.ru
ORCID iD: 0000-0003-4251-7545

M.D., Dr.Sc.(Med), Full Prof., Academician of the Russian Academy of Sciences; Director, University Clinic, Medical Scientific and Educational Institute, Lomonosov Moscow State University; Head, Dept. of Urology and Andrology, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10; Moscow

Valery K. Karpov

Lomonosov Moscow State University; GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Email: vk_karpov@mail.ru
ORCID iD: 0000-0001-7644-4263

M.D., associate professor, Cand. Sc. (Med), Leading Researcher, Urology and Andrology Unit, University Clinic, Medical Scientific and Educational Institute, Lomonosov Moscow State University; associate professor of the Dept. of Urology and Andrology, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10; Moscow

Ahmedkhan M. Pshikhachev

Central Clinical Hospital of Civil Aviation; Moscow State Technical University

Email: pshich@yandex.ru
ORCID iD: 0000-0002-4424-3261

MD, Professor of the Department of Urology and General Surgery at the Moscow State Technical University Medical Institute, Deputy Chief Physician for Medical Work at the Central Clinical Hospital of Civil Aviation

Russian Federation, 125367, Moscow, Ivankovskoe highway, 7; Maykop, Republic of Adygea

Anar M. Tahirzade

GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Email: Anar391@rambler.ru
ORCID iD: 0009-0003-5398-4218

M.D., Cand. Sc. (Med), Head, Urology Division

Russian Federation, 119415, Moscow, Lobachevsky str., 42

Olga Yu. Nesterova

Lomonosov Moscow State University

Email: oy.nesterova@gmail.com
ORCID iD: 0000-0003-3355-4547

M.D., Cand. Sc. (Med), Urologist, Researcher, Urology and Andrology Unit, University Clinic, Medical Scientific and Educational Institute; senior lecturer of the Dept. of Urology and Andrology, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10

Emil M. Mamedov

Lomonosov Moscow State University

Email: mamedo.98@mail.ru
ORCID iD: 0009-0002-6490-8395

Resident of the Department of Urology and Andrology, Faculty of Fundamental Medicine, Moscow Scientific Research Institute, Moscow State University

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10

Misak M. Ekhoyan

GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Email: miso83@list.ru
ORCID iD: 0009-0008-5944-063X

a urologist at the urological department 

Russian Federation, 119415, Moscow, Lobachevsky str., 42

Boris M. Shaparov

Lomonosov Moscow State University; GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Email: uroboris@mail.ru
ORCID iD: 0000-0002-0232-1567

Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University; M.D., Cand. Sc. (Med), urologist of the urological department of GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10; 119415, Moscow, Lobachevsky str., 42

Omar A. Osmanov

Lomonosov Moscow State University; GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Author for correspondence.
Email: omar_osmanov07@mail.ru
ORCID iD: 0000-0003-1453-9771

Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University; urologist at the Department of Urology of the GBUZ City Clinical Hospital No. 31 named after academician G.M. Savelieva of Moscow Healthcare Department

Russian Federation, 119234, Moscow, Lomonosovsky Prospekt, 27, building 10; 119415, Moscow, Lobachevsky str., 42

References

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  9. Demaeyer L, Holz S, Pamart D, Taylor S, Naudin M. Robotic management of painful Zinner syndrome, case report and review of literature. Int J Surg Case Rep. 2020;73:61-64. doi: 10.1016/j.ijscr.2020.06.078. Epub 2020 Jun 22. PMID: 32634620; PMCID: PMC7338681. - robotic assisted laparoscopy are safe and effective and should currently be considered as the surgical gold standard.
  10. Kamalov A.A., Karpov V.K., Pshihachev A.M., Andreytsev I.L., Takhirzade T.B., Ekhoyan M.M., Gevorkyan Z.A. Surgical treatment of Zinner syndrome. Urologiia. 2022;4:60–62. DOI: https://dx.doi.org/10.18565/urology.2022.4.60-62. Russian (Камалов А.А., Карпов В.К., Пшихачев А.М., Андрейцев И.Л., Тахирзаде Т.Б., Эхоян М.М., Геворкян З.А. Хирургическое лечение синдрома Циннера. Урология. 2022;4:60–62 Doi: https: //dx.doi.org/10.18565/urology.2022.4.60-62).

Supplementary files

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2. Fig. 1. Frequency of occurrence of various symptoms in Zinner syndrome. Adapted from [7]

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3. Fig. 2. Computed tomography of the abdominal organs with intravenous contrast, 3D reconstruction of the excretory phase (A); magnetic resonance imaging of the pelvic organs, T2-weighted image

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4. Fig. 3. Intraoperative picture of the vas deferens cyst

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