Robot-Assisted Laparoscopic Resection of the Mesonephric Duct Remnant in a Patient with Zinner Syndrome.

Autor:	Kwenda EP; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA., Locke RA; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA., Archer JS; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA., Su LM; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA., Shenoy A; Department of Pathology, University of Florida College of Medicine, Gainesville, Florida, USA., DeMarco RT; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA., Bayne CE; Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA.
Jazyk:	angličtina
Zdroj:	Journal of endourology case reports [J Endourol Case Rep] 2020 Sep 17; Vol. 6 (3), pp. 198-201. Date of Electronic Publication: 2020 Sep 17 (Print Publication: 2020).
DOI:	10.1089/cren.2020.0020
Abstrakt:	Introduction: A 17-year-old male with Zinner syndrome, a right seminal vesicle cyst, and a solitary left kidney presented with chronic pelvic pain. Previous surgeons had attempted robot-assisted laparoscopic seminal vesicle cyst aspiration and transurethral resection of the ejaculatory duct. Neither surgery provided sustained symptom relief. Abdominal and pelvic MRI showed a cystic structure lodged between the prostate and bladder. The right seminal vesicle, kidney, and ureter were not observed. Materials and Methods: A robot-assisted laparoscopic seminal vesiculectomy was planned. Dissection distal to the right vas deferens and between the bladder neck and prostate revealed a cystic seminal vesicle-like structure. Attached to this was a tubular structure coursing deep to the vas deferens from the right renal fossa. This was presumed to be a dysplastic ureter. The dysplastic ureter was transected from the seminal vesicle and the seminal vesicle was marsupialized to the deep pelvis. Proximally, the dysplastic ureter was transected and left open. Results: Histologic assessment of the specimen revealed an ∼12.1 cm tubular mesonephric remnant. The postoperative course was uncomplicated. At 6 months follow-up, the patient remains free of symptoms with preserved ejaculatory volume. Conclusions: Mesonephric duct abnormalities and symptoms present on a spectrum. We present a safe and effective resection of a mesonephric duct remnant from a 17-year-old male with Zinner syndrome. A robotic approach localized to the right allowed for excellent observation without compromising left-sided genitourinary anatomy. In males presenting with renal agenesis and pelvic symptoms, clinicians should be suspicious of Zinner syndrome and other mesonephric abnormalities. Competing Interests: No completing financial interests exist. (Copyright 2020, Mary Ann Liebert, Inc., publishers.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu