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Seminal Vesicle Hypoplasia With Contralateral Renal Agenesis
Images in Clinical Urology Seminal Vesicle Hypoplasia With Contralateral Renal Agenesis Mustafa Resorlu, Gurhan Adam, Fatma Uysal, Sercin Bas, Ozan Karatag, and Eyup Burak Sancak Renal agenesis is a rare condition of unknown etiology frequently seen together with ipsilateral seminal vesicle and vas deferens anomalies because of common embryologic development. However, no cases of contralateral seminal vesicle hypoplasia accompanying renal agenesis have previously been reported. We describe a case of contralateral seminal vesicle hypoplasia accompanying renal agenesis incidentally detected in a 27-year-old presenting to the urology clinic with pelvic pain. UROLOGY 84: e6, 2014. 2014 Elsevier Inc.
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27-year-old unmarried male patient presented to our hospital with pelvic pain and dysuria. Physical examination was normal and laboratory tests were within normal aside. At ultrasonography, the right kidney was not seen in the normal location or in the pelvis. Magnetic resonance imaging showed a stump-shaped left seminal vesicle and right ureteral hypoplasia accompanying right kidney agenesis (Fig. 1). Sperm counts and morphology were normal in the spermiogram but 80% were immotile. To our knowledge, contralateral seminal vesicle hypoplasia accompanying renal agenesis has not been previously reported. In embryologic development, the mesonephric canal differentiates to form the bladder hemitrigone, seminal vesicle, ejaculatory duct, and vas deferens. The shaping of the adult kidney takes place with the mesonephric blastema. The ureteric bud that develops from the distal mesonephric canal is responsible for metanephric blastema differentiation. This association in embryogenesis causes renal anomalies to accompany seminal vesicle anomalies.1,2 If damage occurs before the seventh week of gestation, this leads to renal agenesis.3 In our case, right-side renal agenesis was accompanied by left-side seminal vesicle hypoplasia. There is no common embryologic process between the kidney and the contralateral seminal vesicle. This suggests that the comorbidity determined was incidental.
Figure 1. A right urethral hypoplasia accompanying right kidney agenesis (A) and a stump-shaped left seminal vesicle (B) were present at magnetic resonance imaging. The red circles represent renal agenesia in panel A and seminal vesicle hypoplasia in panel B.
References Financial Disclosure: The authors declare that they have no relevant financial interests. From the Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey; and the Department of Urology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey Reprint requests: Mustafa Resorlu, M.D., Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart Universitesi, Terzioglu Yerleskesi, Barbaros Mh, 17100, Canakkale, Turkey. E-mail: [email protected] Submitted: April 29, 2014, accepted (with revisions): May 12, 2014
ª 2014 Elsevier Inc. All Rights Reserved
1. Mishra A. Renal agenesis: report of an interesting case. Br J Radiol. 2007;80:167-169. 2. Livingston L, Larsen CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol. 2000;175:177-180. 3. Arora SS, Breiman RS, Webb EM, et al. CT and MRI of congenital anomalies of the seminal vesicles. AJR Am J Roentgenol. 2007;189: 130-135.
http://dx.doi.org/10.1016/j.urology.2014.05.013 0090-4295/14
e7
A
27-year-old unmarried male patient presented to our hospital with pelvic pain and dysuria. Physical examination was normal and laboratory tests were within normal aside. At ultrasonography, the right kidney was not seen in the normal location or in the pelvis. Magnetic resonance imaging showed a stump-shaped left seminal vesicle and right ureteral hypoplasia accompanying right kidney agenesis (Fig. 1). Sperm counts and morphology were normal in the spermiogram but 80% were immotile. To our knowledge, contralateral seminal vesicle hypoplasia accompanying renal agenesis has not been previously reported. In embryologic development, the mesonephric canal differentiates to form the bladder hemitrigone, seminal vesicle, ejaculatory duct, and vas deferens. The shaping of the adult kidney takes place with the mesonephric blastema. The ureteric bud that develops from the distal mesonephric canal is responsible for metanephric blastema differentiation. This association in embryogenesis causes renal anomalies to accompany seminal vesicle anomalies.1,2 If damage occurs before the seventh week of gestation, this leads to renal agenesis.3 In our case, right-side renal agenesis was accompanied by left-side seminal vesicle hypoplasia. There is no common embryologic process between the kidney and the contralateral seminal vesicle. This suggests that the comorbidity determined was incidental.
Figure 1. A right urethral hypoplasia accompanying right kidney agenesis (A) and a stump-shaped left seminal vesicle (B) were present at magnetic resonance imaging. The red circles represent renal agenesia in panel A and seminal vesicle hypoplasia in panel B.
References Financial Disclosure: The authors declare that they have no relevant financial interests. From the Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey; and the Department of Urology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey Reprint requests: Mustafa Resorlu, M.D., Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart Universitesi, Terzioglu Yerleskesi, Barbaros Mh, 17100, Canakkale, Turkey. E-mail: [email protected] Submitted: April 29, 2014, accepted (with revisions): May 12, 2014
ª 2014 Elsevier Inc. All Rights Reserved
1. Mishra A. Renal agenesis: report of an interesting case. Br J Radiol. 2007;80:167-169. 2. Livingston L, Larsen CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol. 2000;175:177-180. 3. Arora SS, Breiman RS, Webb EM, et al. CT and MRI of congenital anomalies of the seminal vesicles. AJR Am J Roentgenol. 2007;189: 130-135.
http://dx.doi.org/10.1016/j.urology.2014.05.013 0090-4295/14
e7