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? 

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  • Dr. Anil Takvani
    Dr. Anil Takvani
    25 Jun 2020 09:06:39 AM

    @Dr. Sahil,

    I think you have create confusion between ejaculatory duct obstruction and vas deferens obstruction. Both these entities are different.
    Looking to USG findings, forget conclusion with that title of your post let us focus on ejaculatory duct obstruction in 13 year patient,
    Your case is not fitting exactly in Zinner Syndrome as seminal vesicle is normal as per USG report attached. You have EDO on right side with ipsilateral ?renal agenesis.
    I would like to request Prof. Venugopal to enlighten us on your case with that I am requesting member to share their experience and expert comments....Thanks

  • Sahil sheikh
    Sahil sheikh
    25 Jun 2020 11:56:02 AM


    There is no vasal obstruction. It is dilated. Should I get MRI PELVIS done?

  • Sahil sheikh
    Sahil sheikh
    25 Jun 2020 02:50:23 PM

    Yes sir. Would love to have venugopal sir 's opinion

  • Venugopal P
    Venugopal P
    13 Jul 2020 09:20:35 AM


    Dear All,

    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 anomaly.

    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,




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