Images – Large symptomatic seminal vesicle cyst treated with robotic-assisted seminal vesiculectomy

Zinner syndrome is a congenital abnormality of the mesonephric duct and consists of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction.1 These findings are due to arrested development in embryogenesis, which affects the caudal end of the Mullerian duct. Fewer than 100 cases have been reported to date. Seminal vesicle (SV) cysts may also be acquired and have been associated with benign prostatic enlargement, prostatic surgery, and malignancy.2 Though most often asymptomatic, the most common symptoms are lower urinary tract symptoms (LUTS; dysuria and frequency) and perineal pain.3 Treatment options for symptomatic cysts include surgical excision, transurethral de-roofing, and aspiration. Minimally invasive approaches provide an opportunity to maximize surgical results while minimizing morbidity. To date, only a few cases of robotic-assisted laparoscopic seminal vesiculectomy have been described. We report the largest SV cyst in the current literature to be managed by robotic-assisted laparoscopic vesiculectomy