Zinner syndrome is a rare congenital malformation defined by a classic triad: ipsilateral ejaculatory duct obstruction, seminal vesicle cyst, and renal agenesis. Symptoms vary with the size of the cyst, its relationship to adjacent organs, and associated anomalies. Surgical intervention is recommended for symptomatic pediatric patients. While comprehensive excision has often been advocated to prevent recurrence, a combined approach of cyst aspiration and maximal cyst wall ablation may offer equally lasting relief with far less morbidity.

A 14-year-old boy with a long history of voiding difficulties presented with acute urinary retention; catheterization drained 530 mL of urine. Renal function was normal, with a serum creatinine of 0.8 mg/dL and an estimated glomerular filtration rate of 102 mL/min/1.73 m². Pelvic magnetic resonance imaging revealed a 5 cm × 4 cm × 3.5 cm cystic lesion arising from the right posteroinferior prostate and compressing the bladder, together with right renal agenesis—findings that pointed to Zinner syndrome.

Using a 7.5F pediatric compact cystoscope, the team accessed the ejaculatory duct through the verumontanum and applied a holmium:YAG laser via a 270-μm fiber at 0.8 J and 10 Hz to ablate the obstructing cyst wall, drain the cyst, dilate the duct opening and perform maximal wall ablation. The patient was discharged on postoperative day one without complications, and the catheter was removed on day three. Uroflowmetry showed a maximum flow rate of 23 mL/s with a post-void residual of 18 mL, and at one year he remained completely asymptomatic, with only a small residual cyst on ultrasound. As the authors conclude, combining aspiration with wall ablation is an effective, safe and durable option for large seminal vesicle cysts.

The work titled “Minimally invasive management of large seminal vesicle cyst in Zinner syndrome: Laser ablation for urinary retention” was published in UroPrecision (published on January 28, 2026).
DOI:10.1002/uro2.70049