UNASSIGNED: Zinner syndrome is a rare congenital anomaly featuring a unilateral seminal vesicle cyst and ipsilateral renal agenesis. While the majority of affected patients are asymptomatic and followed with conservative management, others have symptoms such as micturition, ejaculatory difficulties, and/or pain, thus may require treatment. These patients often undergo an invasive procedure as first-line treatment, such as transurethral resection of the ejaculatory duct, or aspiration and drainage, which reduces pressure within the seminal vesicle cyst, or surgical resection of the seminal vesicle. Reported here is a patient with ejaculation pain and pelvic discomfort associated with Zinner syndrome who was successfully treated in a non-invasive manner with silodosin, an α1-adrenoceptor antagonist.
UNASSIGNED: A 37-year-old Japanese male had ejaculation pain and pelvic discomfort associated with Zinner syndrome. Two months of treatment with silodosin, an α1-blocker, resulted in complete pain relief. Thereafter, conservative management with regular follow-up examinations has been conducted for five years, without recurrence of ejaculation pain or other symptoms associated with Zinner syndrome.
UNASSIGNED: This is the first known published case report of a patient with Zinner syndrome treated with silodosin who was completely relieved from ejaculation pain. The effect of α1-adrenoceptor antagonists to inhibit seminal vesicle contraction, as well as cause relaxation of smooth muscles of the urethra and prostate may contribute to reduce pain associated with ejaculation. We concluded that silodosin treatment should be attempted in affected patients before considering surgical treatment.

Background: Similar to other secretory organs, the male spermatic ducts may develop calculi. However, this condition is described as rare in literature and usually affects the seminal vesicles. As far as we know, no cases of calculi in the ampulla of the ductus deferens have been published so far. Patients with seminal vesicle calculi usually complain of hematospermia, painful ejaculation, perineal or testicular discomfort or pain, and often experience significant impairment of quality of life. Case Presentation: We present a case of a 39-year-old patient who presented himself in an external urologic practice with recurrent hematospermia and painful ejaculation. According to the diagnosis of a seminal vesicle calculus of 1 cm in length on the right side, the patient underwent a transurethral vesiculo- and ampulloscopy with a semirigid ureteroscope whereby the stone could be located in the ampulla of the ductus deferens and removed in toto. Conclusion: Lithiasis should be kept in mind when examining patients with hematospermia and ejaculation pain. Transurethral ampulloscopy is an efficient, safe, and minimally invasive method for stone removal from the ampulla of the ductus deferens.