Robot-Assisted Radical Prostatectomy in a Patient With Zinner Syndrome: A Case Report.

INTRODUCTION: Zinner syndrome is a rare congenital urogenital anomaly characterized by seminal vesicle cysts, ejaculatory duct obstruction, and ipsilateral renal agenesis. Surgical treatment for prostate cancer in this setting has been reported in only 2 previous cases. CASE PRESENTATION: A 67-year-old man with congenital left renal agenesis presented with voiding dysfunction. Magnetic resonance imaging identified a 6-cm seminal vesicle cyst and a Prostate Imaging-Reporting and Data System category 4 prostatic lesion. Serum prostate-specific antigen was 1.3 ng/mL. Prostate biopsy revealed Gleason score 3 + 3 = 6 adenocarcinoma. Robot-assisted laparoscopic radical prostatectomy was performed using the posterior approach. Despite anatomical complexity and adhesions, the procedure was completed safely. Postoperative prostate-specific antigen became undetectable, and the patient achieved pad-free continence at 6 months. CONCLUSION: Robot-assisted laparoscopic radical prostatectomy was safely performed for prostate cancer arising in Zinner syndrome. Robot-assisted surgery is particularly valuable for complex anatomy caused by congenital anomalies.