Abstract
BACKGROUND Zinner syndrome is a rare congenital anomaly of the male genitourinary system, characterized by the classic triad of features: a seminal vesicle cyst, unilateral renal agenesis, and vas deferens obstruction. This article presents a clinical case of a 36-year-old patient with this rare condition and describes the results of his successful laparoscopic surgical treatment. CASE REPORT A 36-year-old man with a 2-year history of infertility and chronic pelvic pain received a diagnosis of Zinner syndrome, characterized by the triad of left renal agenesis, ipsilateral ureteral atresia, and a large seminal vesicle cyst. He underwent successful laparoscopic excision of the cyst. The cyst contents (approximately 120 mL of light-brown fluid) were aspirated, followed by meticulous enucleation. The cyst, remnant seminal vesicle tissue, and distal atretic ureter (3 cm) were completely resected. Histopathological examination confirmed a benign, multilocular cyst lined by columnar epithelium with glandular metaplasia and chronic inflammation, with no evidence of malignancy. The postoperative course was uneventful. At 3-month follow-up, the patient reported complete resolution of pain and normalized urination. Semen analysis showed significant improvement: ejaculate volume increased to 1.6 mL, sperm concentration to 1.4×10⁷/mL, and progressive motility to 35%, indicating partial recovery of ejaculatory function. The case demonstrates that laparoscopic surgery is an effective treatment for Zinner syndrome, alleviating symptoms and potentially improving fertility parameters. CONCLUSIONS This case highlights the importance of timely recognition of Zinner syndrome, especially in patients with unilateral renal agenesis and pelvic pain, and demonstrates the effectiveness of the laparoscopic approach as a method of choice in the symptomatic course of this pathology.