Zinner syndrome: Clinical insights from Western Norway

Zinner syndrome (ZS) is characterised by unilateral renal agenesis, ipsilateral seminal vesicle cyst and obstruction of the ejaculatory duct. Although rare, urologists may encounter it at some point in their clinical practice. The literature is largely limited to case reports, and the condition is poorly understood. Our objective was to report on cases of ZS that have been managed at two centres in order to gain further clinical insights on this condition.

A retrospective review was conducted on ZS cases presenting at two centres in Western Norway between January 2021 and June 2024. Data were collected on demographic details, symptomatology, imaging findings, management and fertility outcomes.

Six cases were identified that met the full triad for ZS, with ages ranging from 18 to 70 years. Five patients were symptomatic at presentation, reporting issues such as anejaculation and testicular pain during sexual activity. Two cases presented as emergencies, one with acute urinary retention and the other with severe pelvic pain. Half of the patients were successfully managed with a conservative approach. Two-thirds had children, either through natural conception or assisted reproductive methods, while the remaining patients underwent sperm cryopreservation.

ZS presents with a wide range of symptoms and at varying ages. Not all symptomatic cases require surgical intervention, and management should be individualised. In select cases, a conservative approach can feasible.