Zinner’s syndrome: report of two cases and review of the literature

Background

Congenital malformations of the seminal vesicle are uncommon, and most of them are cystic malformations. If an insult occurs between the 4th and the 13 h gestational week, the embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens could be altered. Cysts of the seminal vesicle may appear with a mass effect, dysuria, epididymitis, or obstruction of the gastrointestinal and genitourinary tracts. Approximately two thirds of them are associated with ipsilateral renal agenesis, because both the ureteral buds and seminal vesicles originate from the mesonephric (Wolffian) duct. They were first described by Zinner in 1914, and 200 cases of seminal vesicle cysts associated with ipsilateral renal agenesis have been reported in the literature. Most patients with this anomaly are asymptomatic until the third or fourth decade of life. Some cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. Transrectal ultrasonography provides good visualization of the pelvic structures and allows guidance for aspiration of the cysts.

Case presentation

We present two cases of seminal vesicle cyst. The first patient had dysuria, increased frequency of urination, and haematuria. He was operated and benefited from a removal of the cyst with right ureterectomy and left ureteral reimplantation. The second patient had disorder of the digestive transit and he benefited from a laparoscopic removal of the cyst.

Conclusions

Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Usual symptoms that are caused by the seminal vesicle cysts are bladder irritation and obstruction as well as pain in the perineum and scrotum. Epididymitis is frequently found. Treatment consists to removing the seminal vesicle cyst.

     

Absence de corrélation génotype-phénotype dans les absences de canaux déférents

Absence of the vas deferens is a rare cause of male infertility, associated with mutations in the cystic fibrosis transmembrane regulator (CFTR) gene in about 80% of cases. Only limited published data are available concerning the correlation between genotype and reproductive tract abnormalities observed in this disease: presence or absence of seminal vesicles and parts of the epididymis, symmetrical or asymmetrical lesions, testicular volumes. We screened 47 patients for the 13 most common CFTR mutations on the cystic fibrosis gene and for the 5-thymidine variant of the polythymidine tract of intron 8. Renal, scrotal and transrectal ultrasonography was performed in each patient to explore the testes and reproductive tract. All patients presented absence of the ampullae of the vas deferens. Forty patients presented bilateral absence of the vas deferens and 7 presented unilateral absence of the vas deferens. At least one mutation of the cystic fibrosis gene was present in 64% of cases: 47% had the ΔF 508 mutation and 63% had the 5T allele. No mutation was detected in seventeen patients, including 3 patients with unilateral renal agenesis and 3 patients with unilateral absence of the vas deferens. No differences were observed for seminal vesicles and symmetry of vesicular and epididymal abnormalities between patients with or without CFTR gene mutations, but epididymal abnormalities were significantly more frequent in the group without mutation (p=0.01). Testicular volumes were significantly lower in the patients without mutation or with the 5T allele only, than in the patients with at least one CFTR gene mutation: 10.7±4.1 ml versus 15.1±4.5 ml, respectively (p<0.001). In conclusion, in cases of isolated absence of the vas deferens, there is no difference in sperm duct abnormalities between patients with or without CFTR gene mutation. These results suggest that other genetic or environmental determinants are required to explain a common pathogenesis for these malformations. The decreased testicular volume of patients without CFTR gene mutation or with the 5T allele only suggests the existence of an unidentified secretory or mixed factor involved in these forms of absence of the vas deferens.     

Kyste de la vésicule séminale associé à une agénésie rénale homolatérale: à propos de trois observations

The combination of seminal vesicle cyst and homolateral renal agenesis is a rare congenital anomaly. However, this anomaly is diagnosed more frequently due to progress in medical imaging. The authors report three cases of seminal vesicle cyst associated with ipsilateral renal agenesis in two cases and ectopic ureter in one case. All cases presented nonspecific clinical symptoms. The diagnosis was suspected on imaging (ultrasound and computed tomography). Treatment was surgical in two cases and endoscopie in one case. The authors review the literature on the aetiology and pathogenesis of seminal vesicle cyst, its association with homolateral renal agenesis and diagnostic and therapeutic methods.     

Immunohistochemical demonstration of placental protein 5 (PP5) -like material in the seminal vesicle and the ampullar part of vas deferens

Placental protein 5 (PP5), originally isolated from normal placenta (1), has recently been identified in the seminal plasma (2). We undertook a series of immunohistochemical experiments in order to find out the source of the seminal plasma PP5-immunoreactive material. Immunoperoxidase staining for PP5 was positive in the ampullar part of vas deferens and the seminal vesicle, while testis, epididymis, vas deferens, seminal vesicle, prostate and urethra were negative.     

Imagerie des glandes annexes de la voie séminale

Ultrasonography (US) is presently routine part of the investigation of infertile men with low volume ejaculate. It provides excellent depiction of the congenital or acquired obstructive lesions of the reproductive system, particulary in its distal part. For 10 years, we performed a US examination of the kidneys, the scrotum contents and transrectal US (TRUS) in every case a excretory cause of male hypofertility could be suspected. In selected patients, MR imaging (with endorectal coil) appears usefull. We describe the normal and abnormal anatomy of the epididymis, vas deferens, seminal vesicle (SV) and ejaculatory ducts in male infertility with US and MRI. Dilatation of the small ducts in the epididymis and sometimes in the testis at scrotal US is suggestive of a downstream obstacle. Sometimes these dilatation could appear as small hypoechoic areas in the epididymis. In contrast, post-inflammatory changes are hyperechoic but often associated with dilatations. TRUS permits to confirm the absence of the vas deferens in congenital bilateral absence of vas deferens (CBAVD): it shows the absence of the ampullae and severe abnormalities of the SV. In case of unilateral absence of the vas deferens, the association with a homolateral kidney agenesis does not lead to the screening for mutations in the cystic fibrosis gene, but suggests a wolffian duct abnormality. MRI (with endorectal coil) is indicated when TRUS is unconclusive. Scrotal US permits to guide semen aspiration and TRUS is indicated to eliminate a distal obstruction when a surgical anastomosis is planed. TRUS (as well as scrotal US) can suggest an obstacle when dilatation of one or several segments of the seminal tract is observed. Sometimes the cause is obvious with imaging: CBAVD, prostatic cyst, inflammatory and post-infectious changes, lithiasis etc. However, it remains many cases where US is only one component of the therapeutic decision, besides clinical examination, sperm count, FSH level and biochemical sperm markers.     

L’agenesie bilaterale congenitale des deferents a l’heure de I’ICSI

Congenital bilateral absence of the vas deferens is the most frequent abnormality of the male genital tract Diagnosis is clinical. Seminal patterns associate azoospermia, hypospermia, low PH, low seminal markers. Transrectal and renal ultrasonography search for abnormalities of the seminal vesicles and renal agenesis. Mutations of CFTR gene are found in more than 70% of all cases. Genetic council is necessary before ICSI. Results of ICSI with micro-epididymal sperm aspiration are the same as in the other cases of azoospermia.     

Immunohistochemical localization of substance P, vasoactive intestinal polypeptide and gastrin-releasing peptide in vas deferens and seminal vesicle, and the effect of these and eight other neuropeptides on resting tension and neurally evoked contractile activity

Immunohistochemical studies of the vas deferens and seminal vesicle of mouse, guinea-pig, and rabbit showed the presence of nerve fibres containing vasoactive intestinal polypeptide (VIP), substance P (SP), and gastrin-releasing peptide (GRP) supplying the smooth muscle layers as well as blood vessels. The nerve supply was better developed in the seminal vesicle than in the vas deferens. The motor activity of the vas deferens and seminal vesicle of the guinea-pig was studied in vitro. The vas deferens responded to transmural electrical stimulation with a twitch followed by a slow contraction. The twitch was blocked by guanethidine and tetrodotoxin, but not by atropine, propranolol, phenoxybenzamine, or fluphenazine. The slow contraction exhibited features of an alpha-receptor-mediated response. SP, physalaemin and eledoisin contracted the smooth muscle and also potentiated the twitch response to electrical nerve stimulation in a concentration-dependent manner. The SP blocking agent, (D-Pro2,D-Trp7,9)-SP, affected neither the resting tension nor the response to electrical stimulation. It is therefore suggested that the SP fibres act mainly prejunctionally. VIP, Leu-enkephalin, cholecystokinin octapeptide (CCK-8), angiotensin II, vasopressin, neurotensin, bombesin, and GRP had no effect on either the resting tension or the response to electrical nerve stimulation. The seminal vesicle responded to electrical stimulation with a contraction which was unimpaired by atropine, propranolol, phenoxybenzamine, and guanethidine, but abolished by tetrodotoxin. Hence, this contraction is mediated by a non-adrenergic, non-cholinergic neurotransmitter. Bombesin, GRP, SP, physalaemin and eledoisin contracted the smooth muscle and potentiated the response to electrical stimulation. VIP, Leu-enkephalin, CCK-8, angiotensin II, vasopressin, and neurotensin had no effect on the resting tension or on the response to transmural electrical stimulation. The SP antagonist abolished the contraction elicited by SP but did not influence the response to nerve stimulation. The results suggest that the SP and GRP nerves may have prejunctional and facilitating postjunctional effects in the seminal vesicle.     

Coexistence and cooperation between neuropeptide Y and norepinephrine in nerve fibers of guinea pig vas deferens and seminal vesicle

Fluorescence immunocytochemistry of guinea pig vas deferens and seminal vesicle revealed dense networks of nerve fibers containing both neuropeptide Y (NPY) and dopamine-beta-hydroxylase (DBH), a marker for adrenergic neurons. The effects of norepinephrine (NE) and NPY on the smooth musculature of these organs were studied in vitro. NE inhibited the response to electrical nerve stimulation and increased the basic tension in the vas deferens and contracted the smooth muscle of the seminal vesicle, but had no effect on the contractile response to transmural stimulation in the latter organ. NPY had similar effects on the vas and vesicula, i.e. it inhibited the electrically induced contractions and had no effect on the basic tension. The results suggest a role for NPY as a transmitter that acts before the site of the neuromuscular junction to modulate the release of other transmitters from motor nerve fibers in the smooth musculature.     

Developmental and hormonal regulation of specific proteins in mouse vas deferens and seminal vesicle.

This paper is concerned with hormonal regulation of the developmental pattern of major proteins of the mouse vas deferens (mouse vas deferens protein: MVDP, 34.5 kD) and seminal vesicle (15.5, 120 and 140 kD) whose expression is regulated by testosterone at adulthood. The ontogeny of these proteins, studied by SDS-polyacrylamide gel electrophoresis, appeared to be uncoordinated. MVDP was not accumulated until animals were 20 days old and its concentration increased sharply from 20 to 30 days of age. In seminal vesicle, the 15.5 kD protein did not accumulate before day 30 whereas 120 and 140 kD proteins appeared and accumulated between 30 and 40 days. In 30-day-old mice castrated at birth or treated with cyproterone acetate over 29 days, MVDP levels were not abolished and were similar to those measured in 20-day-old males. Testosterone administration, from 1 to 10 days of age, did not induce precocious expression of MVDP. These results suggest that the neonatal expression of MVDP is independent of androgens. In seminal vesicle, the first expression of the 3 proteins studied was dependent upon testicular androgens as shown by neonatal castration and injection experiments. The marked increase in the levels of the 4 proteins studied, during sexual maturation, was not associated with quantitative or qualitative changes in tissular androgen concentrations, suggesting that other factors may be necessary for protein expression. Whereas thyroxine may induce a precocious accumulation of MVDP, prolactin had no stimulatory effect on the accumulation of proteins from vas deferens and seminal vesicle. The results suggest that during sexual maturation gene activation by androgens was progressive.     

Ultrastructure and function of the seminal vesicle of Bittacidae (Insecta: Mecoptera)

The fine structure of the seminal vesicle and reproductive accessory glands was investigated in Bittacidae of Mecoptera using light and transmission electron microscopy. The male reproductive system of Bittacidae mainly consists of a pair of testes, a pair of vasa deferentia, and an ejaculatory sac. The vas deferens is greatly expanded for its middle and medio-posterior parts to form a well-developed seminal vesicle. The seminal vesicle is composed of layers of developed muscles and a mono-layered epithelium surrounding the small central lumen. The epithelium is rich in rough endoplasmic reticulum and mitochondria, and secretes vesicles and granules into the central lumen by merocrine mechanisms. A pair of elongate mesodermal accessory glands opens into the lateral side of the seminal vesicles. The accessory glands are similar to the seminal vesicle in structure, also consisting of layers of muscle fibres and a mono-layered elongated epithelium, the cells of which contain numerous cisterns of rough endoplasmic reticulum and mitochondria, and a few Golgi complexes. The epithelial cells of accessory glands extrude secretions via apocrine and merocrine processes. The seminal vesicles mainly serve the function of secretion rather than temporarily storing spermatozoa. The sperm instead are temporarily stored in the epididymis, the greatly coiled distal portion of the vas deferens.     

The congenital and acquired solitary kidney

The embryonic insult that results in unilateral renal agenesis may involve not only the ureteral bud but also other mesonephric duct derivatives, including the seminal vesicles, vas deferens, and epididymis; in the female with a solitary kidney, müllerian duct anomalies frequently occur. Normal renal development depends upon a normal ureteral bud, which undergoes orderly branching and penetrates the metanephric blastema at about the fifth week of gestation. Ureteral and kidney development are thought to be interdependent, and when there is failure of the ureteral bud to form or absence of the nephrogenic ridge, the kidney does not develop normally. Unilateral renal agenesis is compatible with normal longevity and does not predispose the contralateral kidney to greater-than-normal risk; nevertheless, patients should have annual surveillance, including a blood pressure measurement, serum creatinine if not initially normal, and urinalysis to detect proteinuria. Removal of one kidney leads to structural and functional changes by the remaining kidney, including increased filtration of the remaining glomeruli. These functional changes have generally been considered beneficial because they mitigate the reduction in the total glomerular filtration rate that would otherwise occur, but experimental evidence suggests that these changes may have an adverse effect on the remaining kidney. Clinical evidence shows that these changes do not lead to renal deterioration in kidney donors because the renal function of kidney donors is well preserved in over 20 years of follow-up after donor nephrectomy.     

平疣桑椹石磺生殖系统结构及精子储存场所

雌雄同体贝类精子的储存和利用规律一直是国内外贝类生物学研究的难点之一,本文利用活体解剖、显微观察、组织切片和扫描电镜技术,综合研究了平疣桑椹石磺(Platevindex mortoni)的生殖系统及精子储存场所。结果显示,其生殖系统包括生殖器本部、雌性生殖部分和雄性生殖部分。生殖器本部由两性腺、两性输送管、蛋白腺、黏液腺、支囊组成;雌性生殖部分包括输卵管、受精囊、阴道,位于身体中后方体腔内;雄性生殖部分包括输精管、刺激器、阴茎、阴茎鞘和阴茎牵引肌,位于身体前端右侧体腔内;其阴茎有阴茎鞘,阴茎表面布满倒刺。平疣桑椹石磺阴茎为直线状,无雄性附属腺。未交配的性成熟个体支囊内充满细长精子,受精囊内无精子;而交配后充当雌性个体的支囊内均为细长的自体精子,受精囊内有大量活力较强的粗短精子,其支囊为自体精子的存储场所,而受精囊为异体精子的存储场所。其精子储运情况为:两性腺内精子成熟后暂存于支囊,交配时通过输精管运输至阴茎,由阴茎输送精子至对方的阴道,异体精子进入受精囊内存储待用。     

Neonatal exposure to oestrogens alters the protein profiles and gene expression in the genital tract of adult male mice.

After neonatal administration of supraphysiological doses of oestradiol, the concentration of tissue proteins, in adult mice, was significantly reduced by 39, 45 and 56% in epididymis, vas deferens and seminal vesicle respectively. The protein profiles showed persistent alterations. In epididymis, 4 protein bands were differentially increased (14.4, 43 and 67 kDa) or reduced (24 kDa) in oestrogenized males. In vas deferens, 4 proteins were increased (14.4, 49,67 and 76 kDa) and one (34 kDa) virtually absent. In seminal vesicle, about 20 proteins of varying molecular weights (12-140 kDa) were differentially increased or decreased. Testosterone substitution, at adulthood, was unable to reverse these effects. Treatments with oestradiol during adult life induced persistent alterations in the protein profiles of the 3 organs but, in contrast to neonatal treatment, these alterations could be reversed by androgen therapy. A cDNA library has been constructed with RNA prepared from adult seminal vesicle and screened by differential hybridization. Neonatal oestrogenization strongly reduced the abundance of some mRNA species. Eleven recombinants containing putative oestrogen-sensitive sequences were isolated. Two of them, having an insert of about 500 base pairs, were used for dot-blot hybridization. Results showed that the two clones contained sequences which were differently regulated by androgens.     

The occurrence of GABA in vas deferens, prostate, epididymis, seminal vesicle and testicle of the rat

The concentration of gamma-aminobutyric acid (GABA) was determined in vas deferens, prostate, epididymis, seminal vesicle and testicle of the adult rat. Among the organs examined, vas deferens was found to be the richest in GABA and the lowest concentration was measured in testicle. Although the GABA levels appear to be 10-50 times lower in the sex organs examined than in the brain tissue, even the low GABA contents are suggestive of a role of this amino acid in the reproductive organs of the male rat.     

Development of spermiduct and seminal vesicle during pharate adult of the cabbage armyworm,Mamestra brassicae, (Lepidoptera; Noctuidae)

Summary

Development of the upper vas deferens and seminal vesicle, and the ecdysteroid titers of the cabbage armyworm (Mamestra brassicae) during pharate adult stage were investigated to provide evidence of endogenous control of the sperm movement through the reproductive tract. Apparently, development of the upper vas deferens is initiated when ecdysteroid titers increase after pupation and continues until eclosion. Sperm movement correlates with the decrease of ecdysteroid titers. When ecdysteroid titers remained at low levels, sperm release from the testis was observed one day before eclosion.     

3种蛾类雄性内生殖系统形态学研究

为了探究蛾类昆虫新的有效分类特征,本研究对直脉青尺蛾Geometra valida、白雪灯蛾Chionarctia niveus和多斑豹蠹蛾Zeuzera multistrigata雄性内生殖系统进行了解剖观察和形态学比较。结果表明：3种蛾类雄性内生殖系统均由精巢、贮精囊（前贮精囊和后贮精囊）、输精管、复射精管、单射精管（单射精管原节和单射精管表皮节）和附腺组成;种间形态差异表现在贮精囊的形状及连接方式、复射精管的形状及长短、单射精管和附腺的长度等方面,这些鉴别特征可为蛾类分类及系统发育研究提供形态学借鉴。     

Light and electron microscopic studies on the seminal secretions and the vas deferens of the penaeiodean shrimp,Sicyonia ingentis

Unlike the other penaeiodean shrimp, the ridge back shrimp, Sicyoniaingentis does not produce a spermatophore, but transfers sperm suspended in seminal plasm. This paper reports on the histomorphology and ultrastructure of the vas deferens with reference to its functional role in secreting the sperm bearing materials. The vas deferens is divisible into proximal secretory, mid storage and distal ejaculatory regions. The epithelial cells lining the proximal vas deferens are comprised of secretory and absorptive cell types. The loose sperm cells found in the lumen of this region are in an immature condition, and are agglutinated into a compact mass with signs of spermiogenesis in the mid vas deferens. The epithelial cells lining the mid vas deferens are short flattened cells. The distal vas deferens is ensheathed by muscular fibres. The inner epithelial cells are highly secretory and contain numerous microvilli at the luminal end. The sperm cord gets liquefied in this region facilitating the transfer of sperm in liquid form to the female during mating.     

Two new species of Anchylodiscus Johnston & Tiegs, 1922 (Monogenea) from Plotosus canius (Plotosidae)

Two new species of Anchylodiscus Johnston & Tiegs, 1922, A. malayensis n. sp. and A. liewi n. sp., were obtained from the gills and the dendritic (or arborescent) organ of Plotosus canius, respectively. The two new species have two seminal vesicles; the seminal vesicle nearer the testis is a distension of the vas deferens, while the distal one is similar to the blind seminal vesicle of the majority of freshwater ancylodiscoidines. The blind seminal vesicle suggests that Anchylodiscus should be placed in the subfamily Ancylodiscoidinae.     

The helminth parasites of the lesser flamingo,Phoeniconaias minor (Geoffroy), from Lake Nakuru,Kenya, including a new cestode,Phoenicolepis nakurensis n.g., n.sp.

Summary Seven species of cestodes and two of nematodes are reported from Phoeniconaias minor from Lake Nakuru, Kenya. Phoenicolepis nakurensis n.g., n.sp. (Hymenolepididae) is characterized by the size and shape of the hooks, scolex and strobila, structure of the terminal genital ducts, presence of an accessory sac, external seminal vesicle and stylet, and absence of an internal seminal vesicle. Gynandrotaenia stammeri. Cladogynia phoeniconaiadis, Flamingolepis tengizi, F. dolguschini and Striatofilaria phoenicopteri are redescribed; all except C. phoeniconaiadis are new for this host and for Kenya. ac]19800210Abbreviations as accessory sac - c cirrus - cs cirrus sac - esv external seminal vesicle - g gland cells - gs glandular sheath - isv internal seminal vesicle - md muscular duct - Mg Mehlis' gland - o ovary - pg prostate gland cells - s stylet - sr seminal receptacle - u uterus - v vagina - vd vas deferens - vg vitelline gland     

Pararhinebothroides hobergi n. gen. n. sp. (Eucestoda: Tetraphyllidea) in Urobatis tumbesensis (Chondrichthyes: Myliobatiformes) from coastal Ecuador.

A new species of tetraphyllidean eucestode inhabiting Urobatis tumbesensis from inshore waters of southeastern Ecuador shares 3 synapomorphies with Rhinebothroides spp.: apical bothridial suckers poorly differentiated from the marginal loculi, internal seminal vesicles, and insertion of the vas deferens dorsally closer to the poral than the aporal end of the cirrus sac. The new species differs from Rhinebothroides spp. by lacking medial bothridial septa and loculi and having symmetrical ovarian arms, and possesses an apparent autapomorphic trait by having the vas deferens tapering to a narrow tube before entering the cirrus sac, extending posteriorly to the posterior end of the cirrus sac where it expands into an external seminal vesicle running ventral to the cirrus sac anteriorly to anterior to the vagina. In Rhinebothroides spp., the vas deferens is expanded into an external seminal vesicle near the insertion into the cirrus sac As the sister group of Rhinebothroides, we propose a new genus to accommodate the new species. Phylogenetic evaluation of phyllobothriids recently assigned to Anthocephalum shows that they represent a paraphyletic assemblage of species of varying degrees of relatedness to Rhinebothroides spp. and the new species. Uncovering the relationships of the new species and the various species assigned to Anthocephalum permitted reevaluation of character transformations used in previous phylogenetic analysis of Rhinebothroides. Transformation series for 3 characters, previously based on functional outgroup comparisons, changed and a new character, length of cirrus sac, was added. The new phylogenetic analysis differs from the previous hypothesis only in placing R. scorzai as the sister species of R. circularisi + R. venezuelae + R. moralarai rather than of R. freitasi + R. glandularis + R. mclennanae. The occurrence of the sister species of Rhinebothroides in a Pacific Ocean stingray adds additional support to the hypothesis of Pacific origins of South American freshwater stingrays.