Zinner syndrome is a rare congenital malformation related to an abnormality in the development of the Wolffian duct, the clinical picture of which consists of a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and obstruction of the ejaculatory duct. Chronic perineoscrotal pain may be an indication of the diagnosis of Zïnner syndrome to some extent. We report the observation of a 23-year-old patient, married and father of one child, who presented with chronic perineo-scrotal pain revealing on morphological assessment (ultrasound, uroscanner, prostatic MRI) a cystic formation of the seminal vesicle, left renal agenesis with an empty left renal compartment. Given the patient's refusal of any surgical procedure, treatment consisted of echo-guided puncture of the seminal vesicle cyst bringing back 30 cc of a seroviscous liquid whose analysis revealed spermatozoa, without atypical cells, compatible with a cyst. The clinical evolution was marked by a progressive remission of the scrotal pain with a delay of several months.

Emphysematous pyelonephritis (EPN) is a severe form of urinary tract infection with a high mortality unless treated rapidly and effectively. Our objective is to review our experience over 15 years (from 2005 to 2020) on conservative treatment according to clinical, bacteriological, radiological, therapeutic and evolutionary aspects of EPN. We analyzed the medical record of patients treated for EPN at the Urology service of Mohammed the VIth University Hospital of Marrakesh. There were 18 patients with an average age of 54 years. They were all diabetics. Lithiasis obstruction of the upper excretory tract was found in 15 patients (83%). The germs involved were Gram-negative bacilli, especially E. coli (61% in our series) followed by Staphylococci (22.2%), Klepsiella (11.1%), and proteus mirabilis in 5.5% of cases. Resuscitation measures, including antibiotic and insulin therapy, were introduced as a matter of urgency for patients if needed. In 77.8% of cases, treatment was conservative: 11 patients (61.1%) underwent endoscopic drainage with a JJ stents and 3 patients (16.6%) underwent open drainage of peri-renal collections with a nephrostomy tube placement). Only 4 patients (22.2%) patients underwent nephrectomy. No deaths were observed during the course.