Zinner Syndrome: Modern Methods of Diagnosis and Treatment. Literature Review and Clinical Cases

Zinner syndrome (ZS) is a rare abnormality, described for the first time in 1914 by A. Zinner. The syndrome is caused by malformation of the ureteral bud at the early stages of embryogenesis, result in ipsilateral renal and the other structures anomalies originated from the mesonephric duct. In most patients (80.8%) it is diagnosed at the 2nd–4th decade of life, when the disorder manifests with various symptoms, in the others – it is asymptomatic and diagnosed accidentally or in dispensary medical examinations. Broad use of modern imaging methods, as ultrasound diagnostics, computed tomography, magnetic resonance іmaging (MRI), allows to diagnose this complex syndrome at the early stages, at a younger age and in previously asymptomatic patients. The clinical manifestation of the ZS is wide-ranging and non-specific for this pathology. The symptoms can be present in various diseases including non-urological. The treatment strategy depends on the disease severity, imaging data and consists of surveillance, conservative and surgical approaches. The objective: to summarize the results of diagnostics and treatment methods of the ZS based on our clinical practice and literature review. Materials and methods. From 2014 to 2020 in the SI “Academician O. F. Vozianov Institute of Urology of NAMS of Ukraine” eight patients with ZS, aged 22–39 years old, were examined and treated. Results. All patients underwent different types of laparoscopic interventions depends on clinical presentation and imaging data. The outcomes of surgical interventions were favorable and without complications. Conclusions. MRI currently remains the gold standard exam for diagnosis of ZS. Treatment of ZS depends on the results of imaging data, the presence or absence of symptoms, complications, and comorbidities. Today, radical laparoscopic intervention is the most justified treatment for this disease.