Zinner syndrome: Late-Diagnosis in a 55-year-old male and favorable outcome after surgical excision - A case report and review of the literature

Zinner Syndrome (ZS) is a rare congenital anomaly defined by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. We report a 55-year-old male presenting with chronic perineal pain and LUTS. Imaging confirmed ZS (right renal agenesis, 3.3 × 3.8 cm seminal vesicle cyst). The patient underwent surgical excision, converting from laparoscopic to open due to dense adhesions. He achieved complete symptom resolution and remained stable at two-year follow-up. ZS should be considered in older males with non-specific LUTS. Surgery is effective, and advanced imaging is crucial for diagnosis.