13/M with rt testicular enlargement and dilated vas since last 3 years. Usg scrotum showed rt appendix testis tubular dilatation with dilated vas. Got TRUS done. What should be done next?
Yes sir. Would love to have venugopal sir 's opinion
I had posted a commentary along with Others On the topic of
Anejaculation posted in Uroacademy with links for references addressing this
issue with the present plans of management. I would urge all to relook on the
topic ‘Anejaculation’ posted under the section ‘Andrology’ posted on Feb 1st
2020. I am not repeating the same here.
The question posed here is whether the US report provided is
that of Zinner’s Syndrome or not. I do agree with Anil Takvani in that in
Zinner’s Syndrome the Seminal Vesicle is rarely ever reported normal. It may be
aplastic or more often is associated with congenital cyst of varying size. The
ejaculatory duct obstruction is more often due to compression of the Cyst and
hence more proximal in position and not near the verumontanum. The epididymis
can be engorged and dilated tubule can be observed on US. No doubt there is
ipsilateral agenesis of kidney which is part of the diagnosis. There are several
case reports on Zinner’s Syndrome as no one can have a series of this rare
I am providing an article on by Vaibhav Modgil, Asif Muneer et al (2016) on ‘An update on the
diagnosis and management of ejaculatory duct obstruction’ which will provide
further insight into the subject. This is a must read article for those
interested in this field.
With warm Regards,