Ectopic ureter associated with Zinners syndrome in a kidney recipient: case report and literature review

SUMMARY INTRODUCTION Zinner's Syndrome is a triad of mesonephric duct anomalies comprising unilateral renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction. In this study, we present a kidney recipient with ectopic ureter associated with Zinner's syndrome and a literature review. CASE PRESENTATION A 59-year-old male with a history of chronic kidney disease and left renal agenesis underwent deceased donor kidney transplantation. After securing optimal renal functions, the patient underwent abdominal computed tomography (CT) scan for the seroma that occurred under the incision. The final diagnosis was an ectopic distal ureter ending in the seminal vesicle cyst's wall and ipsilateral renal agenesis. The patient was discharged without any complications and the clinical follow up was uneventful. DISCUSSION AND CONCLUSION Congenital seminal vesicle disorders are usually associated with ipsilateral urinary duct anomalies stemming from the same embryonic structure. To our knowledge, this is the first case report that describes kidney transplantation in a patient with ipsilateral renal agenesis and ectopic ureter ending in the seminal vesicle cyst. In patients with renal agenesis, during the ipsilateral urinary tract anastomosis, the possibility of ectopic ureter should be kept in mind otherwise graft loss can occur with a high morbidity rate.

RESUMO INTRODUÇÃO A Síndrome de Zinner é uma tríade de anomalias do ducto mesonéfrico que compreende agenesia renal unilateral, cisto da vesícula seminal e obstrução do ducto ejaculatório. Neste estudo, apresentamos um receptor de rim com ureter ectópico associado à Síndrome de Zinner e revisão da literatura. APRESENTAÇÃO DO CASO Homem de 59 anos com história de doença renal crônica e agenesia renal esquerda foi submetido a transplante de rim de doador falecido. Após função renal ideal, foi realizada tomografia computadorizada do abdome (TC) devido ao seroma sob incisão. O diagnóstico final foi um ureter distal ectópico que termina na parede do cisto da vesícula seminal e agenesia renal ipsilateral. O paciente recebeu alta sem complicações e o acompanhamento clínico ocorreu sem intercorrências. DISCUSSÃO E CONCLUSÃO Os distúrbios congênitos da vesícula seminal geralmente estão associados às anomalias do ducto urinário ipsilateral devido a uma mesma estrutura embrionária. Até onde sabemos, é o primeiro relato de caso que descreve o transplante renal em um paciente com agenesia renal ipsilateral e ureter ectópico terminado no cisto da vesícula seminal. Em pacientes com agenesia renal, durante a anastomose do trato urinário ipsilateral, deve-se ter em mente a possibilidade do ureter ectópico, caso contrário, poderá ocorrer perda do enxerto com alta taxa de morbidade.

Mimosine increases the expressions of tyrosine phosphorylated protein in mouse seminal vesicles / La mimosina aumenta la expresión de la proteína tirosina fosforilada en las vesículas seminales del ratón

Acute effect of purified mimosine (MiMo) extracted from Leucaena leucocephala on testicular histopathology has been documented with seminal vesicle (SV) atrophy. Since protein phosphorylation and seminal secretions play important roles in sperm physiology, this study aimed to study the alteration of substances including tyrosine phosphorylated (TyrPho) proteins in seminal vesicle treated with MiMo. Male mice were divided into a control and experimental groups treated with purified MiMo at 3 doses of 15, 30, and 60 mg/KgBW, respectively for 35 consecutive days. The morphology and weights of SV were compared among groups. The levels of magnesium and fructosamine in SV fluid were assayed. The profiles of equally SV total proteins were compared using SDS-PAGE. The expression of seminal TyrPho proteins was detected by western blotting. Recent results showed the decreased weights of SV in MiMo treated mice compared to control. However MiMo in all doses did not affect the levels of magnesium and fructosamine in SV fluid. The SV protein expression of 130 and 55 kDas was obviously decreased in a high dose MiMo. In dose-dependent response, the expressions of 72 and 55 kDas TyrPho proteins of SV were increased. In conclusion, MiMo could affect SV morphological size and protein secretions especially TyrPho proteins.

El efecto agudo de la mimosina purificada (MiMo) extraída de Leucaena leucocephala en la histopatología testicular se ha documentado con atrofia de vesícula seminal (VS). Debido a que la fosforilación de proteínas y las secreciones seminales tienen un papel importante en la fisiología de los espermatozoides, este estudio tuvo como objetivo estudiar la alteración de sustancias como la proteína tirosina fosforilada (TyrPho) en vesículas seminales tratadas con MiMo. Los ratones se dividieron en un grupo control y un grupo experimental y se trataron con MiMo purificado en 3 dosis de 15, 30 y 60 mg / KgBW, respectivamente, durante 35 días seguidos. La morfología y los pesos de VS se compararon entre los grupos. Fueron analizados los niveles de magnesio y fructosamina en el fluido VS. Los perfiles de las proteínas totales de VS se compararon utilizando SDS-PAGE. La expresión de la proteína TyrPho en las vesículas seminales se detectó mediante transferencia de Western blot. Los resultados recientes muestran la disminución del peso de las VS en ratones tratados con MiMo, en comparación con el grupo control. Sin embargo, en ninguna de las dosis se vieron afectados por mimosina purificada los niveles de magnesio y fructosamina en el líquido de las VS. La expresión de la proteína en VS de 130 y 55 kDas disminuyó notablemente en una dosis alta de MiMo. En la respuesta dependiente de la dosis, aumentaron las expresiones de 72 y 55 kDas de las proteínas TyrPho en las VS. En conclusión, la mimosina purificada podría afectar el tamaño morfológico de las VS y la expresión de proteínas, especialmente las proteínas TyrPho.

Ultrassonografia no auxílio do diagnóstico de vesiculite seminal em touros de corte / Ultrasonography in the diagnosis of seminal vesiculites in beef bulls

A vesiculite é um processo inflamatório das glândulas vesiculares, podendo ser unilateral ou bilateral, que acomete reprodutores. O objetivo do presente trabalho foi avaliar a utilização da ultrassonografia como meio de diagnóstico precoce das alterações das vesículas seminais em touros. O presente trabalho foi realizado no município de Videira, Santa Catarina. Analisou-se um total 42 reprodutores, com média de idade de 15 meses, das raças Aberdeen Angus e Polled Hereford em semi-confinamento. Foi realizado exame clinico do estado geral dos animais e exame andrológico dos reprodutores. As amostras de sêmen para a realização do exame das características físicas do ejaculado foram obtidas por eletroejaculação. Através da palpação retal, realizou-se a avaliação das glândulas vesiculares por ultrassonografia. A análise estatística dos dados foi realizada por meio de análise de variância (ANOVA) para comparação entre médias com nível de significância de 5%. A presença de vesiculite foi observada em 31 animais (73,8%) dos 42 analisados. Dos 31 animais portadores 11 animais (35,5%) apresentaram vesiculite bilateral e 20 apresentaram vesiculite unilateral (64,5%; P<0,05). Animais com perímetro escrotal maior tendem a desenvolver vesiculite unilateral, tal fato pode ser explicado pela precocidade sexual agravado pela sodomia entre os animais. O uso do ultrassom auxilia de forma preventiva a detecção de animais portadores de vesiculite em reprodutores.(AU)

The vesiculite is an inflammatory process of the vesicular glands, unilateral or bilateral, that affects bulls. The purpose of this study was to evaluate the use of ultrasound as a complementary method for early detection of changes in seminal vesicles in bulls. This study was conducted in the municipality of Videira, Santa Catarina. We evaluated 42 bulls, with an average age of 15 months, Aberdeen Angus and Polled Hereford breeds and in semi-confinement. Clinical animal examination and andrological exam were performed in all animals. Semen samples were obtained by electroejaculation and physical characteristics of the ejaculate were performed. Rectal palpation was performed by ultrasonography to evaluate vesicular glands changes. Statistical analysis of the data was performed using analysis of variance (ANOVA) for comparison between means with significance level of 5%. The presence of vesiculitis was observed in 31 (73.8%) from the 42 analyzed bulls. Of the 31 animals, 11 animals (35.5%) presented bilateral vesiculitis and 20 showed unilateral vesiculitis (64.5%; P<0.05). Animals with a larger scrotal perimeter tend to develop unilateral vesiculitis, which can be explained by the sexual precocity observed by sodomy among animals. In this way, the use of ultrasound helps preventively to detect animals with vesiculitis in breeding animals.(AU)

Methotrexate changes the testicular tyrosine phosphorylated protein expression and seminal vesicle epithelia of adult rats / El metotrexato cambia la expresión de la proteína testicular-tirosina fosforilada y el epitelio vesicular seminal en ratas adultas

Methotrexate (MTX) is commonly used as a chemotherapy agent and immune system suppressant but its adverse effect on male reproductive system is still limited. This study aimed to investigate the effect of MTX on structure and functional proteins of testis and seminal vesicle. Adult male rats were divided into control and MTX groups (n =12). In 30 experimental days, the treated animals were injected with MTX (tail i.v., 75 mg/KgBW) at days 8 and 15. Then, the reproductive parameters and histology of both groups were examined. Thickness of seminal seminal vesicle epithelia was analyzed. Also, the expressions of testicular tyrosine phosphorylated proteins and steroidogenic acute regulatory (StAR) protein were investigated. The results showed that MTX could significantly decrease epididymal sperm concentration. In addition, the germ cell degeneration, increased spaces of interstitial tissues, and low epididymal sperm mass density were observed in MTX group. The thickness of seminal vesicle epithelia in MTX group was significantly lower than that of control group. Moreover, the intensity of testicular phosphorylated proteins of 31, 32, 72, and 85 kDas was significantly increased while of 42 and 47 kDas in MTX group was decreased as compared to control. The expression of testicular StAR protein in MTX group was also significantly decreased as compared to the control. In conclusion, MTX affects testicular and seminal tissues and changes testicular functional proteins in adult rats.

El metotrexato (MTX) se usa comúnmente como agente de quimioterapia y supresor del sistema inmunitario, pero su efecto adverso en el sistema reproductor masculino sigue siendo limitado. Este estudio tuvo como objetivo investigar el efecto del MTX sobre la estructura y las proteínas funcionales del testículo y la vesícula seminal. Ratas macho adultas se dividieron en grupos control y grupo con MTX (n = 12). En 30 días experimentales, a los animales tratados se les inyectó MTX (cola i.v., 75 mg / KgBW) los días 8 y 15. Luego, se examinaron los parámetros reproductivos y la histología de ambos grupos. Se analizó el espesor del epitelio de la vesícula seminal. Además, se investigaron las expresiones de la proteína tirosina testicular fosforilada y de la proteína reguladora aguda esteroidogénica (StAR). Los resultados mostraron que el MTX podría disminuir significativamente la concentración de espermatozoides epididimarios. Además, se observó la degeneración de las células germinales, el aumento de los espacios de los tejidos intersticiales y la baja densidad de masa del espermatozoide epididimal en el grupo de MTX. El grosor del epitelio de la vesícula seminal en el grupo MTX fue significativamente menor que el del grupo control. Además, la intensidad de las proteínas testiculares fosforiladas de 31, 32, 72 y 85 kDas aumentó significativamente, mientras que la de 42 y 47 kDas en el grupo MTX disminuyó en comparación con el control. La expresión de la proteína StAR testicular en el grupo MTX también se redujo significativamente en comparación con el control. En conclusión, el MTX afecta los tejidos testiculares y seminales y cambia las proteínas funcionales testiculares en ratas adultas.

Resolución laparoscópica de tumores de vesícula seminal: presentación de 2 casos y revisión de la literatura / Laparoscopic resolution of seminal vesicular tumors: 2 cases report and literature review

RESUMEN La patología tumoral de las vesículas seminales es extremadamente poco frecuente. Sólo existen reportes de series de casos que no logran ser más de 150 en todo el mundo. Por lo mismo, no existen pautas de recomendación para el diagnóstico y tratamiento. A propósito de 2 casos de tumores de vesículas seminales ocurridos en un período de 12 meses en nuestro centro, hemos decidido realizar una revisión de la literatura actual sobre el estudio y manejo de esta patología poco frecuente. La sintomatología es inespecífica, y su diagnóstico comprende una combinación de test sanguíneos, imagenológicos e histopatológicos en su mayoría para descartar otras neoplasias. El tratamiento es multimodal el cual incluye resección quirúrgica donde la vía laparoscópica es el patrón de oro, asociado a adyuvancia con hormonoterapia y/o radioterapia. Su pronóstico es pobre debido al diagnóstico en etapas avanzadas, por lo que se requiere un alto índice de sospecha diagnóstica para lograr realizar un tratamiento oportuno.(AU)

Abstract The tumor pathology of the seminal vesicles is extremely rare. There are only reports of series of cases that fail to be more than 150 worldwide. For this reason, there are no recommendation guidelines for diagnosis and treatment. With regard to 2 cases of seminal vesicle tumors that occurred in a period of 12 months in our center, we decided to review the current literature on the study and management of this rare pathology. The symptomatology is non-specific, and its diagnosis includes a combination of blood, imaging and histopathological tests, mostly to rule out other neoplasms. The treatment is multimodal, which includes surgical resection where the laparoscopic approach is the gold standard, associated with adjuvance with hormone therapy and / or radiotherapy. Its prognosis is poor due to the diagnosis in advanced stages, which is why a high index of diagnostic suspicion is required to achieve an opportune treatment.(AU)

Effect of sesame-supplemented diet on prostate and seminal vesicle histology of adult rat / Efecto de la dieta suplementada con sésamo en la histología de la próstata y vesícula seminal de ratas adultas

Infertility is a great concern among the people of reproductive age. The use of natural products obtained from traditional herbs is appealing. Studies show that antioxidants are important in improving male infertility. Thirty adult male rats were randomly divided into two regimen and control groups. The regimen group received diet containing 30 % sesame seed, while the control group received standard diet for 12 weeks. Histology of prostate and seminal vesicle were evaluated and serum levels of FSH, LH and testosterone concentrations were assessed as well. The results showed that, the diameter of peripheral epithelium and the volume density of the prostate epithelium increased but the volume density of the prostate stroma was decreased significantly in the regimen group compared to the control group. Central epithelium diameter and the volume density of the prostate lumen did not change significantly between two groups. In seminal vesicle, volume density of fibromascular and lumen decreased significantly in regimen group compared to control group. FSH and Testosterone level did not change while LH concentration increased significantly in the regimen group compared to the control group (P <0.03). This study shows that the sesame seed might improve male rat reproductive systems by histopathological changes in prostate and seminal vesicle.

La infertilidad es una gran preocupación para las personas en edad reproductiva y el uso de productos naturales obtenidos a partir de hierbas tradicionales es interesante. Los estudios demuestran que los antioxidantes son importantes en la mejora de la infertilidad masculina. Treinta ratas macho, adultas, se dividieron aleatoriamente en dos grupos, experimental y control. El grupo experimental recibió dieta con un 30 % de semillas de sésamo, mientras que el grupo control recibió dieta estándar durante 12 semanas. Fueron evaluadas la histología de próstata y vesícula seminal, así como los niveles séricos de las concentraciones de FSH, LH y testosterona. Los resultados mostraron que el diámetro del epitelio periférico y la densidad de volumen del epitelio de la próstata aumentaron, pero la densidad de volumen del estroma de próstata se redujo significativamente en el grupo experimental en comparación con el grupo control. El diámetro del epitelio central y la densidad de volumen del lumen de la próstata no presentaron cambios significativos entre los dos grupos. En la vesícula seminal, la densidad de volumen fibromuscular y el lumen se redujeron significativamente en el grupo de régimen en comparación con el grupo control. FSH y el nivel de testosterona no cambiaron, mientras que la concentración de LH aumentó significativamente en el grupo de régimen en comparación con el grupo control (P <0,03). Este estudio indica que la semilla de sésamo podría mejorar los sistemas reproductivos de ratas macho a partir de cambios histopatológicos en la próstata y las vesículas seminales.

Morfología testicular del yaque Leiarius marmoratus (Pisces: Siluridae) en estadio de madurez reproductiva / Testicular morphology of yaque Leiarius marmoratus(Pisces: Siluridae) in maturity reproductive stage

El conocimiento de la morfología y fisiología del testículo, permite generar bases para el entendimiento del comportamiento reproductivo de las especies, ya que diferencias anatómicas están relacionadas con el desempeño reproductivo. Con el fin de contribuir al conocimiento biológico y reproductivo del yaque Leiarius marmoratus, fueron analizadas las características anatómicas, morfológicas y funcionales del testículo en animales durante el estado de madurez reproductiva. En L. marmoratus los testículos están ubicados ventralmente a la vejiga gaseosa y presentan numerosas y largas digitaciones que terminan en un conducto espermático. Microscópicamente se encontró que el testículo es espermatogonial irrestricto de tipo tubular, donde la porción anterior presenta actividad espermatogénica, que disminuye en la porción media y desaparece en la región distal, dando paso a tejido glandular con actividad secretora, que actúa como vesícula seminal. Al interior de cada túbulo testicular, se observan cistos que contienen células espermáticas en el mismo estadio de desarrollo. Basados en las características microscópicas, fueron identificados espermatocitos, espermátides y gran cantidad de espermatozoides libres en el lumen. También fueron identificadas células glandulares, tejido muscular liso y tejido epitelial. En el ducto espermático (región media y distal), se encontró abundante secreción acidofílica que en algunas regiones estaba acompañada de espermatozoides libres.

Knowledge of the morphology and physiology of the testis, leads to generate bases for understanding the reproductive behavior of species, because the anatomical differences are related to reproductive performance. To contribute to biologic and reproductive knowledge of Yaque Leiarius marmoratus, anatomic, morphologic and functional characteristics of the testis in animals in a state of reproductive maturity were analyzed. In L. marmoratus, the testicles are located ventrally to the gas bladder and have many long finger-like structures that finish in spermatic duct. Microscopically it was found that the testis is espermatogonial unrestricted and tubular type, where the anterior portion presented spermatogenic activity, which diminishes in the medium portion and disappears in the caudal portion, leading to tissue with glandular secretory activity serving as a seminal vesicle. Inside each tubule of the testis, there are cysts containing sperm cells within the same stage of development. Based on microscopic features, were identified spermatocytes, spermatids and a large amount of free sperm into the lumen. Glandular cells were also identified, as well as smooth muscle tissue and epithelial tissue. In the spermatic duct (medium and distal portion), acidophilous secretion was abundant and in some regions were accompanied by free spermatozoa.

Esquistossomose mansônica em vesícula seminal / Schistosomiasis mansoni in the seminal vesicle

Em regiões endêmicas, a esquistossomose mansônica é responsável por uma alta taxa de morbimortalidade por doenças associadas à infestação do sistema hepático. O acometimento genital pela schistosomiasis mansoni é raro. Nós relatamos o primeiro caso de esquistossomose mansônica em vesícula seminal diagnosticado, incidentalmente, pelo exame histopatológico da próstata e vesículas seminais removidos cirurgicamente.

In endemic regions, Mansoni schistosomiasis is responsible for high morbidity-mortality rates due to diseases associated with infestation of the hepatic system. Genital involvement caused by Mansoni schistosomiasis is rare. We report the first case of Mansoni schistosomiasis in the seminal vesicle, which was diagnosed incidentally by means of histopathological study of the prostate and seminal vesicles after surgical removal.