Successful treatment of ejaculation pain with silodosin in patient with Zinner syndrome: a case report

Zinner Syndrome: The Diagnosis and Management of a Rare Urogenital Malformation

“…Those with mild symptoms or who prefer noninvasive treatment have the option to use α 1-adrenoceptor antagonists to manage ejaculation pain and pelvic discomfort. A Uetani et al study reported one case of ZS being successfully treated without recurrence of the seminal vesicle cyst over a 5-year follow-up period [ 8 ]. Still, more research is needed to properly evaluate the efficacy of this method in the long term.…”

“…Typically, patients with small cysts (< 5 cm) are asymptomatic. For these cases, it may be appropriate to consider less aggressive treatment methods [ 8 ]. Moderately sized cysts (5–12 cm) are associated with a more severe presentation including dysuria, pelvic pain, and infertility.…”

Potential pharmacotherapy for Zinner syndrome

“…Given the anatomical abnormalities of Zinner syndrome, treatments aimed only at symptomatic relief, such as the use of antibiotics and painkillers, are limited in their effectiveness. However, a fascinating recent case report by Uetani et al has described the successful pharmacological treatment of pain during ejaculation in a patient with Zinner syndrome ( 7 ). The authors describe marked improvements in their patient’s clinical symptoms, including ejaculatory pain and pelvic discomfort, as a result of treatment with silodosin, an alpha-blocker medication.…”

“…Thus, in the case reported by Uetani et al , it would be plausible that the alleviation of symptoms resulted from the suppression of prostatitis-related manifestations rather than the drug directly affecting seminal vesicle dilation. However, imaging studies of the patient showed a reduction in seminal vesicle dilation following treatment with silodosin ( 7 ). Although the exact causal relationship between alpha-blockers and the observed reduction in seminal vesicle dilation requires further investigation, the treatment holds promise as a therapeutic alternative that might be considered before more invasive interventions.…”